Chapter 5: Services

5.1 Assistive Technology Evaluations

5.1.1 Job Function

Assistive technology evaluations are conducted to determine the most effective assistive technology to meet the consumer's vocational or scholastic needs.

5.1.2 Qualifications

Education, Training, and Experience

Assistive technology evaluators must

  • have a degree from an accredited college or university with a specialization in computer science, education, rehabilitation, or related field, with one year work experience in the education or rehabilitation of persons who have visual disabilities and/or other disabilities, or a high school diploma or GED with four years of progressively responsible work experience in the education or rehabilitation of persons who have visual disabilities and/or other disabilities;
  • be knowledgeable about computers and assistive technology, applications of technology, and methods of evaluating technology for persons who are blind or visually impaired;
  • possess the ability to simulate computer and technological environments similar to the situations an individual may encounter on the job or in school;
  • have the ability to conduct objective evaluations;
  • have the ability to make objective recommendations; and
  • demonstrate proficiency in conducting technology evaluations on specific assistive equipment in accordance with Division for Blind Services (DBS) standards and periodic proficiency tests conducted by DBS.

 

Proficiency Tests

Assistive technology evaluators must pass proficiency tests administered by the Assistive Technology Unit (ATU) in Austin before they can be approved to evaluate a DBS consumer's ability to benefit from the purchase of assistive equipment in achieving a vocational or scholastic goal.

Phase I testing may be completed at the DBS ATU in Austin or online at the discretion of the DBS ATU staff. Phase II testing is completed at the DBS ATU in Austin.

Phase II testing can be scheduled two weeks after successful completion of Phase I.

Service providers are responsible for all travel costs related to Phase I and Phase II testing including transportation, food, and lodging. Costs will not be reimbursed.

Periodic performance checks are also conducted by the Employment Assistance Services (EAS) specialist or his or her designee.

 

In-Service Training Requirement for Service Providers

Contract service providers are encouraged to budget funds for each evaluator to attend a yearly conference or workshop relating to assistive technology. At a minimum, each evaluator must attend a technology vendor demonstration or Train the Trainer Workshop in Austin offered by DBS.

 

Provider Authorization

Services must not be provided to DBS consumers until DBS has issued written authorization and a service authorization and/or purchase order (PO). No service by a provider's employee will be paid for if the service is provided before written authorization is given. For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets of this manual.

 

Product Authorization

Each assistive technology evaluator must pass a product-specific proficiency test before evaluating DBS consumers on that specific product. DBS maintains a list of approved assistive technology evaluators and the products they are authorized to evaluate consumers on. To maintain DBS approval, the evaluator must obtain new models, upgrades, or versions of the equipment and software that he or she has been authorized for within 45 days of notice that the new product is available.

 

Staff-to-Consumer Ratio

Assistive technology evaluations must be conducted one-on-one with one staff member for each consumer.

 

On-Site Visits

DBS has the right to conduct initial and periodic on-site visits to verify that each contract service provider (or potential provider) meets DBS minimum requirements for assistive technology evaluators or that the provider has evaluators on staff who meet DBS minimum requirements.

On-site visits may include

  • observation of a provider conducting an evaluation or training,
  • observation of the service being provided, and
  • confirmation that the provider is using the latest versions of software and products on the approved product list.

5.1.3 Service Delivery

Scope of Services

Assistive technology evaluations determine the most effective assistive technology for the consumer's vocational or scholastic needs. Assistive technology evaluations give DBS consumers access to

  • the services of a knowledgeable assistive technology evaluator, and
  • the latest assistive equipment.

When not conducted by DBS, assistive technology evaluations must be conducted at the provider's facility.

 

Referral

DBS requires the consumer's DBS counselor or case manager to

  • consult with an EAS specialist or trained designee for the consumer's EAS initial consultation or basic consultation before referring the consumer for assistive technology evaluations, and
  • provide the assistive technology evaluator with a copy of the consumer's EAS Consultation Report or Basic Consultation Report and any specific referral forms required by the provider before the evaluation begins.

The provider shares the responsibility of securing an EAS report or referral forms and service authorization before scheduling an assistive technology evaluation for a DBS consumer. Note: A service authorization must be obtained before any services are provided to DBS consumers.

An assistive technology evaluator may request a consumer's

  • EAS Consultation Report,
  • Basic Consultation Report,
  • Assistive Technology Support Services Report,
  • Baseline Assessment, or
  • typing test scores.

Consultation reports must be less than one year old. Typing tests are conducted if the consumer is being evaluated for computer-based assistive technologies.

 

Referral Requirement—Exception

The only exception to the requirement for an EAS Consultation Report or Basic Consultation Report applies to consumers who require evaluation for a stand-alone and/or portable video magnifier. A video magnifier uses a video camera's zoom lens to project magnified text and images to a monitor or screen. Stand-alone, portable, luggable, and hand-held video magnifiers do not connect to a computer system.

 

Minimum Assessment Requirements

DBS requires most consumers to have

  • a typing speed of at least 30 words per minute (WPM), and
  • a braille reading speed of 50 WPM in Grade 2 using braille devices, when braille is the preferred reading format.

These minimum assessment requirements are evaluated on a case-by-case basis. For example, these requirements may be waived for consumers who have secondary disabilities that limit the use of one or both hands and for consumers who have sustained a traumatic brain injury. The evaluator should discuss these circumstances with the consumer's counselor or case manager as appropriate.

 

Initial Assessment for Assistive Technology

If initial assessments indicate that the consumer does not meet the minimum requirements for typing or braille reading, the evaluator may substitute a demonstration for the evaluation. The evaluator should

  • discontinue the formal evaluation process,
  • explain to the consumer why the evaluator cannot recommend the purchase of assistive technology at the current time, and
  • document demonstration results in reference to visual accommodations only (rather than work or school environments).

 

Evaluation Period for Assistive Technology

The initial interview should generally require between 30 minutes and one hour. Other segments of the evaluation process generally require two and three hours to complete. However, the length of time required to complete an assistive technology evaluation is based on the consumer's individual circumstances. Therefore, there are no set requirements as to the amount of time each evaluation will require.

 

Conducting the Evaluation

The evaluator must

  • remain impartial and objective throughout the evaluation process;
  • not express personal opinions, comments, or other actions that may be mistaken for bias or promoting one product over another during the evaluation;
  • show consumers only the products indicated on the EAS Consultation Report or Basic Consultation Report during the evaluation (Written approval must be obtained from the consumer's counselor, case manager, or EAS specialist before any additional products are introduced to the consumer);
  • conduct the evaluation (including the evaluator's interview with the consumer) in a confidential manner; and
  • not grant any person permission to observe the evaluation unless
    • the consumer expressly agrees to allow the person to be present; and
    • the observer agrees not to ask questions, make suggestions, or otherwise comment during the evaluation process.

 

Evaluation Components

Assistive technology evaluations include three components.

  1. A private interview is conducted with the consumer to discuss the individual's background and to review information developed by DBS staff, including the consultation report, if applicable, provided by the EAS specialist.
  2. The consumer's ability (or potential ability) to use assistive technology equipment and to benefit from the contract service provider's recommendations is assessed and observed.
  3. A closing interview is conducted to summarize the results of the evaluation process and is documented in the evaluation report.

 

Interview Process—Overview

Interviews are conducted in a confidential manner. The purpose of the interview is to

  • confirm referral information,
  • confirm the information in the EAS Consultation Report or Basic Consultation Report (except for video magnifier evaluations),
  • elicit additional information from the consumer, and
  • confirm the goals of the evaluation.

Some consumers may experience anxiety related to the evaluation and the use of computers or assistive technology. Therefore, it is important for the evaluator to set a comfortable and relaxed atmosphere.

The evaluator may find it helpful to explain to the consumer exactly what will be done during the evaluation. It should be stressed that the evaluation process is not an evaluation of the consumer, but an opportunity for the consumer to evaluate the equipment.

The evaluator should refrain from saying "I will be teaching you" and instead emphasize that the consumer and evaluator will be working together during the evaluation process. The evaluator should stress to the consumer that he or she should be as specific as possible regarding which piece of equipment works best and why.

For additional information about the interview process, assistive technology evaluators are encouraged to contact the ATU at atu@dars.state.tx.us or (512) 377-0310.

 

Interview Process—All Evaluations

During the interview process for all evaluations, the evaluator should

  • confirm the consumer's identification by checking that the consumer's name is spelled correctly and by verifying the name of the consumer's counselor or case manager;
  • gather personal information relating to the consumer's visual and/or physical disabilities or limitations;
  • ask the consumer if his or her color vision is intact and how vision is affected by glare and eye fatigue;
  • encourage the consumer to describe his or her vision including when it is good or bad and under what circumstances;
  • ask the consumer to produce or describe any low vision aids he or she may have and discuss how and to what extent the consumer uses the aids;
  • ask the consumer to describe any assistive techniques he or she uses to improve what is seen;
  • ask the consumer to describe any physical problems that might interfere with evaluation or future training and inquire specifically about back or neck problems, hearing problems, or nausea; and
  • for consumers who are totally blind, verify (or determine if the information is not apparent from the file)
    • how long the consumer has been totally blind;
    • what methods the consumer uses to take notes, read, write, and perform other daily living skills;
    • whether the consumer reads Grade I and/or Grade II braille and, if so, the consumer's minimum reading speed;
    • what the consumer sees as his or her biggest problem regarding current employment or vocational goals; and
    • the consumer's environmental structuring at home, in the workplace, and/or at school;
  • discuss the physical structure of the consumer's environment and how it affects his or her vision including
    • the natural and artificial light in the consumer's environment;
    • the consumer's work space, including his or her desk and chair; and
    • colors and/or other things that affect how well or how poorly the consumer sees; and
  • discuss the consumer's work and/or school history, including
    • current occupation or occupational goals (List and describe some of the tasks currently required in the job as well as long-range task requirements of the job);
    • anticipated changes (Does the consumer anticipate any company changes that might affect his or her position or job tasks? Does the consumer anticipate any personal changes in his or her occupational goals?);
    • any samples of materials the consumer brings;
    • If the consumer is a student, his or her academic plans (What is his or her degree program or course work? What is his or her current year and anticipated graduation date? What are some of his or her current tasks such as note taking or reading and how is he or she currently handling these tasks?); and
    • current or anticipated tasks (Try to get the consumer to give as much information as possible regarding known or expected tasks).

 

Interview Process—CCTV Evaluations

The evaluator should address the following questions during closed circuit television (CCTV) evaluation interviews:

  • Is color identification critical to the consumer in terms of course work and/or job?
  • Does the consumer use a computer on the job site or at home?

 

Interview Process—Scanner Evaluations

During scanner evaluation interviews, the evaluator should determine

  • if the consumer has significant eye fatigue;
  • if the consumer has CCTV magnification that is too large to be productive;
  • if the consumer feels nauseous when using the CCTV;
  • the nature of the consumer's degenerative eye condition;
  • if the consumer is fully aware of other resources such as
    • the Texas State Library,
    • Recordings for the Blind and Dyslexic, and/or
    • reader services; and
  • the consumer's computer needs in terms of speech or braille access and any tasks the consumer will perform using a scanner including
    • entering scanned documents into a computer (Has the consumer brought samples of documents to be scanned or can he or she describe the documents?), and
    • manipulating scanned documents on a computer.

 

Interview Process—Computer Applications

The following areas should be addressed during evaluation interviews for screen magnification devices, refreshable braille PC screen access devices, and screen review systems:

  • If the consumer is using a computer in his or her current employment, the evaluator should note
    • the kind of computer the consumer is using,
    • the software the consumer is currently using, and
    • the access equipment the consumer is currently using.
  • The evaluator should discuss as many aspects as possible about the consumer's job and take notes and recheck the consumer file for any discrepancies. If possible, the evaluator should use information documented in the file to elicit additional details about the consumer's job tasks and performance expectations.
  • The evaluator should document the consumer's current skill level including
    • typing speed,
    • accuracy, and
    • keyboard familiarity.
  • The evaluator should note the consumer's previous computer experience including
    • the kind of computer,
    • the kind of software,
    • where and when the consumer acquired the previous experience, and
    • whether or not the previous experience was acquired before loss of vision.
  • The evaluator should ask if the consumer has any previous experience with
    • computer access equipment,
    • CCTV or similar devices,
    • computer braille devices,
    • refreshable braille PC screen access devices, and/or
    • synthesized speech devices.

 

Post-Evaluation Discussion

When the interview and product evaluation(s) have been completed, the assistive technology evaluator should

  • discuss the evaluator's equipment recommendations and the consequences of the recommendations with the consumer, and
  • answer any questions the consumer has about the recommendations and/or the evaluation process.

The contract service provider also must remind the consumer that the evaluation process is for the sole purpose of making recommendations and that the decision to purchase (or not to purchase) assistive technology equipment can only be made by the consumer's counselor.

 

Documenting Assistive Technology Evaluations

Evaluation reports must be submitted in the standard format required by DBS using a DARS2867, Assistive Technology Evaluation Report. Confidentiality issues must be adhered to at all times.

Information gathered during the interview and evaluation process does not need to be included in the evaluation report unless it is different from the information noted in the referral packet and/or the consultation report.

 

Submitting Evaluation Reports

Evaluation reports must be completed within seven working days from the date of the evaluation and may be submitted by email to

  • the consumer's counselor or case manager, and
  • the EAS specialist or trained designee who completed the consultation report.

The evaluation report, DARS2867, identifies consumers using only (a) the consumer's first name and last initial and (b) the DBS caseload number. The consumer's Social Security number (SSN) must not be used when contract evaluation reports are submitted by email.

 

Consumer Statistics Worksheet

The DBS consumer statistics worksheet (available by request) summarizes the services provided to individual consumers. Contract service providers must complete the worksheet on a quarterly basis by the following deadlines:

  • December 15 for the 1st quarter (September, October, November);
  • March 15 for the 2nd quarter (December, January, February);
  • June 15 for the 3rd quarter (March, April, May); and
  • September 15 for the 4th quarter (June, July, August).

5.1.4 Product Inventory

On-Site Visits

DBS may conduct initial and periodic on-site visits to verify that each facility-based contract service provider (or potential provider) meets the following requirements:

  • The provider maintains the required minimum inventory of assistive technology equipment and software.
  • The provider has the technical equipment and software required for the specific evaluation for which the provider has (or is seeking) approved status.
  • The provider's technical equipment and software are the latest version or model on the market. (Providers must obtain new models, upgrades, or versions of software within 45 calendar days of notice that the new product is available.)
  • The provider's software programs are full working copies (not demonstration or trial versions).
  • The provider's software is PC compatible (unless an evaluation on Mac equipment is required).

 

Approved Products

DBS consumers are evaluated only on products and equipment included on the DBS-approved product list. To obtain a list of approved products, vendors can call (512) 424-4558.

Questions about the approved product lists may be addressed to the ATU at atu@dars.state.tx.us or (512) 377-0310.

Product categories on the approved product lists include

  • video magnifiers;
  • screen magnification programs;
  • screen magnification programs with speech;
  • screen reader programs;
  • refreshable braille displays;
  • optical character recognition (OCR) scanning software;
  • stand-alone, portable, and USC OCR scanners;
  • QWERTY and braille notetakers;
  • embossers; and
  • speech input software.

Before completing an evaluation on any product that is not included on the DBS list of approved products, the assistive technology evaluator must get approval from the ATU at atu@dars.state.tx.us. The request should be made in writing.

Vendors must submit an up-to-date inventory list within 30 calendar days of each contract award.

 

Minimum Inventory Requirements

Service providers must conduct assistive technology evaluations using at least two competing products. There may be times when there is only one of a "type" of product available, especially when a product is new to the market. In these circumstances, providers are required to obtain written approval from the regional program support specialist. They can contact Consumer Procurement and Client Services Contracting (CPCSC) at (512) 424-4702 to begin the approval process.

 

Video Magnifier Products

All products used in evaluations must be on the DBS-approved product list. Stand-alone video magnifiers must be available in

  • two 14-inch or two15-inch models,
  • two 17-inch models,
  • two 19-inch models, and
  • two 22-inch or two 24-inch models.

Provider must have two competing products from each of the following video magnifier categories:

  • desktop PC access,
  • USB PC access,
  • USB PC access with OCR,
  • luggable,
  • hand-held, and
  • portable.

 

Computer-Based Assistive Technology

The provider must have at least two computer-based assistive technology programs in each of the categories listed below, as defined in the provider's contract and from the most current DBS-approved products list. The products in the following categories must be compatible with the most current version of Microsoft Windows or the agency standard operating system for DBS-issued computer systems for consumers:

  • screen magnification software with speech support,
  • screen reader software,
  • braille translation software,
  • refreshable braille displays,
  • computer-based OCR and/or scanner software,
  • notetakers—QWERTY keyboard,
  • notetakers—QWERTY keyboard with refreshable braille display,
  • notetakers—braille keyboard,
  • notetakers—braille keyboard with refreshable braille display, and
  • braille embossers.

 

Special Technologies

The provider must have a product from the approved products list for

  • speech recognition, and
  • braille translation.

The provider must also have a Mac computer with the current Mac operating system and the newest version of MS Office installed.

 

Synthesizers—External

A minimum of two external synthesizers from the most recently updated DBS list of approved products is required.

 

Synthesizers—Internal

No internal synthesizers are required. Since software synthesizers are included as an integral component of the screen review software package with which the synthesizer will be used, there is no requirement to maintain internal synthesizers separately.

5.1.5 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's assistive technology evaluation needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • During the contract period, did the provider maintain the required minimum inventory of assistive technology equipment and software?
  • During the contract period, did the provider obtain the new models, upgrades, and/or versions of equipment and software within 45 calendar days of notice that the new product was available?
  • Within 30 calendar days of each new contract award, did the provider submit an updated inventory list to DBS?
  • Were all evaluations conducted with a staff-to-consumer ratio of one to one?
  • Did evaluators conduct each evaluation using a minimum of two competing products?
  • Were DBS consumers shown only products and equipment included on the most current DBS list of approved products?
  • Did evaluators follow DBS-required procedures during each evaluation?
  • Did evaluators avoid "leading" the consumer to a particular type of equipment or product?
  • Has the provider submitted all required consumer statistics worksheets to CPCSC (a) in accordance with the DBS-required schedule and (b) using the electronic format provided by DBS?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices no later than 30 calendar days following service completion?

5.2 Assistive Technology Training

In addition to the standards outlined below, contractors that provide assistive technology training services must also comply with requirements outlined in the Assistive Technology Trainer Guidelines and Procedures.

5.2.1 Job Function

Assistive technology training is provided to prepare a consumer to use assistive technology effectively in employment and postsecondary educational settings. Training may be provided at a facility, on-site at a consumer's home or workplace, in a DARS office, or in a community resource center. Group training can be provided by facility-based trainers or on-site trainers.

5.2.2 Qualifications

Education, Training, and Experience

Assistive technology trainers must

  • have a high school diploma or GED,
  • be knowledgeable about computers and assistive technology for people who are blind or visually impaired,
  • be familiar with computer and assistive technology applications for people who have visual disabilities and/or other disabilities,
  • be familiar with appropriate instructional methods for people who have visual disabilities and/or other disabilities,
  • have the ability to vary training to meet the specific needs of each consumer, and
  • demonstrate proficiency in assistive technology training on specific assistive equipment in accordance with DBS standards and periodic proficiency tests conducted by DBS.

 

Proficiency Tests

Assistive technology trainers must pass proficiency tests administered by DBS before providing services to DBS consumers.

  • Phase I testing may be completed at the DBS ATU in Austin or online at the discretion of DBS ATU staff.
  • Service providers must successfully complete Phase I testing a minimum of two weeks before Phase II testing.
  • Phase II testing is conducted at the DBS ATU in Austin.
  • If travel is necessary in order to participate in Phase I or Phase II testing, the service provider must pay for all travel costs including transportation, food, and lodging.

Assistive technology trainers must pass periodic proficiency tests administered and conducted by DBS, as well as periodic performance monitoring conducted by the EAS specialist, regional program support specialist (RPSS) or designated representative.

 

In-Service Training

Contract service providers are encouraged to budget funds for each evaluator to attend a yearly conference or workshop relating to assistive technology. At a minimum, each evaluator must attend a technology vendor demonstration or Train the Trainer Workshop in Austin offered by DBS.

 

Provider Authorization

Services must not by provided to DBS consumers until DBS has issued written authorization and a PO.

No service by a provider's employee will be paid for if the service is provided before DBS written authorization is given.

For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

 

Product Authorization

Assistive technology trainers must meet DBS testing and approval requirements on specific products before providing services to DBS consumers.

DBS proficiency tests are product-specific (separate tests are required for each product). Assistive technology trainers must pass the required tests for each product in order to provide training on each specific product.

DBS maintains a list of approved assistive technology trainers and authorized products for each trainer.

 

Performance

Assistive technology trainers must provide training only on the specific products for which they have met DBS testing and approval requirements.

DBS approval is granted for individual trainers only. DBS approval applies to the individual and not the position held by the individual.

 

Staff-to-Consumer Ratio

For the purpose of conducting assistive technology training, the staff-to-consumer ratio for group training may not exceed one staff member to three consumers (1:3).

 

On-Site Visits

DBS may conduct initial and periodic on-site visits to verify that each contract service provider (or potential provider) meets DBS minimum requirements for assistive technology trainers or that the provider has trainers on staff who meet DBS minimum requirements.

5.2.3 Service Delivery

Scope of Services

Assistive technology trainers provide the following services:

  • baseline assessment;
  • training that includes
    • basic computer hardware and software including keyboarding (for approved facilities only), introduction to computers, introduction to application software, use of the internet, and printing and faxing using computers equipped with assistive software and designed for low vision or blind users;
    • advanced computer hardware and software including advanced skills training in computer hardware and software applications; and
    • assistive technology including training in specific assistive technology products; and
  • post-training assessment

 

Required Curriculum

Assistive technology trainers must use the DBS-established training curriculum. The required curriculum is detailed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual.

 

Predefined Curriculum Modules

Assistive technology trainers must receive predefined curriculum modules for various levels of program skills and/or specific skills. Each module will include appropriate time frames. The required modules are detailed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual, but reasonable flexibility to vary the training curriculum will be authorized in order to accommodate the specific needs of individual consumers.

 

Baseline Assessment

The assistive technology trainer or EAS specialist administers a basic-skills test to each consumer who is referred for assistive technology training. The baseline assessment is used to determine the level of training each consumer requires. The assistive technology trainer requests a copy of the baseline assessment before beginning services. If the baseline assessment has not been completed by the EAS specialist or designated staff member, the assistive technology trainer may complete the baseline assessment and document the results on a DARS2902, Assistive Technology Training: Baseline Assessments. The baseline assessment is included as a separate line item in the PO.

 

Post-Training Assessment

Post-training assessments are used to determine training effectiveness and assess whether the consumer requires additional training. The post-training assessment is conducted by the EAS specialist, vocational rehabilitation counselor (VRC), or assistive technology trainer once training is complete. On average, each assessment takes two to four hours. The EAS specialist, VRC, or designee may observe the post-training assessment. The post-training assessment is documented on form DARS2902 and is listed as a separate line item on the PO. The initial baseline can be used to document if the training met the consumer's training needs and objectives, if the training was effective, and to justify additional training hours. If training services were job- or task-specific, assistive technology trainers must list objectives on the training report and whether the objectives were met. Assistive technology trainers may consult with the EAS specialist or VRC if other objectives are needed that are not listed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual.

 

Authorization for Additional Training

If the post-training assessment indicates the need for additional training that exceeds the maximum number of hours for that module in the assistive technology trainer guidelines, the consumer's counselor or case manager may approve up to 10 additional hours of training.

If additional training is still required, the local DBS regional director may approve up to 10 hours of training in addition to the 10 hours previously approved by the consumer's counselor or case manager.

Training beyond the above limits, if any, must be approved through the supervisory chain of management to the appropriate director of field services, after consultation with the ATU and/or technical support specialists.

 

Changes to Configuration Files

At the end of the last training session, the trainer must provide the consumer with electronic media containing copies of any changes or additions to the consumer's batch, keyboard, script, set, or other configuration files. Trainers must also document changes to configuration files in the technology training report.

 

Consumer Equipment Problems

If a problem is discovered with a consumer's equipment or hardware, the trainer must contact the consumer's counselor or case manager and/or the staff who conducted the consumer's consultation report before leaving the consumer's home. The trainer documents all equipment problems and resulting contacts with DBS staff members in the final training report.

 

Service Limitations

Assistive technology trainers must not

  • make recommendations or discuss additional training time, equipment, or software upgrades with the consumer or in the consumer's presence (These issues are discussed only with the consumer's counselor, case manager, the EAS specialist or trained designee who completed the consultation report);
  • install programs or equipment to a consumer's computer system without prior written approval from the consumer's counselor or case manager (The counselor or case manager must consult with the EAS specialist or trained designee who completed the consultation report before authorizing the installation); or
  • solicit training, consultation, or referrals from consumers.

Assistive technology trainers must document compliance with the above requirements in the narrative portion of the final training report.

 

Interim Training Reports

If consumer training continues beyond one 30-calendar-day period, the trainer must submit an interim training report for each 30-calendar-day period within 10 working days of the close of each 30-calendar-day period.

Training reports for DBS consumers are submitted to the consumers' counselors.

 

Final Training Reports

Final training reports must be submitted within 10 working days from the date training is completed. For more information, see Chapter 3: Rates, 3.5.2 Submitting Service Reports.

Final training reports for DBS consumers are submitted to

  • the consumer's counselor or case manager, and
  • the EAS specialist from the region where the consumer receives services.

 

Documenting Assistive Technology Training

All training reports must be submitted in the standard format required by DBS using a DARS2868, Assistive Technology Training Report. Confidentiality issues must be adhered to at all times.

Information gathered during the training process does not need to be included in the interim or final report unless it is different from the information noted in the referral packet.

 

Submitting Training Reports

Email is the preferred method for submitting assistive technology training reports.

Training reports submitted by email should identify consumers using only (a) the consumer's first name and last initial and (b) the DBS caseload number. The consumer's SSN should never be used when training reports are submitted by email.

Training reports submitted in writing should identify consumers by first name, last initial, and caseload number.

Never use the consumer's full name in the DARS2868, Assistive Technology Training Report.

The DARS2868, Assistive Technology Training Report is used only for documenting training services and information related to the consumer and must not be used to market services to DBS staff members. Forms and reports submitted to DBS are public records. DBS does not provide marketing services for any service provider.

5.2.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet required training objectives for the consumer, which may include
    • minimal keyboarding speed and accuracy levels, and
    • technology-related skills that enable the consumer to independently perform each task?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • Were standard staff-to-consumer ratios observed during the performance of all training services?
  • Were all training services performed using the DBS-established training curriculum?
  • If the curriculum was varied to accommodate the specific needs of an individual consumer, did the trainer contact the consumer's counselor for approval before the training was conducted?
  • If a problem was discovered with a consumer's equipment or hardware, did the trainer immediately contact the consumer's counselor or case manager and/or the EAS specialist who conducted the consumer's consultation report?
  • Was the consumer provided electronic media containing copies of any changes or additions to the consumer's batch, keyboard, script, set, or other configuration files at the end of the final training session?
  • Did the trainer make any recommendations or discuss recommendations regarding additional training time, equipment, or software upgrades with the consumer or in the presence of the consumer?
  • Did the trainer install any program or piece of equipment to the consumer's system without prior written approval from the consumer's counselor or case manager?
  • If consumer training continued beyond one 30-calendar-day period, did the trainer submit the required interim training reports to the consumer's counselor or case manager and the EAS specialist who conducted the consumer's consultation report?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices (including required attachments such as travel logs, if applicable) no later than 30 calendar days following service completion?

5.3 Independent Living Services (Individualized Skills Training Only)

5.3.1 Job Function

Independent living (IL) services are designed to accommodate for the consumer's vision loss in daily living activities.

5.3.2 Qualifications

Education, Training, and Experience

All independent living trainers must

  • have a bachelor's degree from an accredited college or university in rehabilitation, education, psychology, sociology, or related field supplemented with
    • one year work experience in rehabilitation teaching, rehabilitation, or education of people with disabilities, or
    • two years' work experience in general education or other related field; and
  • participate in a presentation of written scenarios and/or hands-on demonstration of skills in providing independent living skills training, preferably with experience in "hands-on" individual training to people who are elderly or who have visual disabilities and/or other disabilities.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service will be paid if the service is provided before DBS written authorization is received.

For additional information, seeChapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.3.3 Service Delivery

Scope of Services

Independent living skills vendors provide the following services in the consumer's residence or local community. The independent living skills vendor may provide one or more of the following services as authorized by the DBS IL worker (ILW):

  • Application Assessment—the process of gathering referral data and information about the consumer’s preliminary need for services. Along with eye medical report(s), this information is used by the ILW to determine eligibility for the Independent Living Program.
  • Comprehensive Assessment—the process of working with the consumer to identify the issues that prevent him or her from functioning independently. This process, which occurs after the ILW determines eligibility, can also help a consumer maintain or increase his or her independence and includes listening to the consumer describe problems related to loss of vision, conducting an in-depth interview to gather information, observing skill demonstrations at home, and talking with family members or caregivers to gather any additional information. The Comprehensive Assessment is used by the ILW to develop the ILP.

Note: Information and referral (I&R) services help the consumer identify and use alternative resources, such as Meals on Wheels, the Texas State Library, and the How To Guide, to meet his or her individual needs. These services can be provided at any point in the independent living process.

  • Independent Living Skills Training—training in techniques that enable a consumer to perform daily living skills in alternative ways. These skills are divided into the following categories:
    • personal management—including grooming, eating, health, safety, clothing identification and coordination, and medication systems;
    • home management—including sewing, cleaning of clothing, housekeeping, meal preparation and kitchen safety skills, planning for grocery shopping, and minor home maintenance;
    • communication—including telling time and time management, using the telephone, money management, writing, organization, and using adaptive devices; and
    • information access and technology—including training on use of magnifiers, CCTVs, and other low-vision devices, as well as adaptations of computers and other types of technology.

 

Designation of Independent Living Worker

The ILW, who is designated by the DBS field director, provides case coordination, direction to the IL skills vendor on service provision, as well as the following services:

  • sends referrals to the IL skills vendor for initial contact and application assessment;
  • enters application information into the electronic case management system;
  • determines consumer eligibility for IL services;
  • refers eligible consumers to the IL skills vendor for comprehensive assessment;
  • develops the ILP with the consumer and enters it into the electronic case management system;
  • authorizes IL skills training hours;
  • manages DBS case records;
  • reviews documentation of services provided by the IL skills vendor;
  • authorizes the purchase of recommended equipment and services;
  • documents the purchase of equipment and services in each consumer's ILP; and
  • arranges or provides more complex services including (but not limited to) braille instruction, orientation and mobility training within the consumer's community, and diabetes education and training.

 

Case Management

The case manager is responsible for:

  • determining consumer eligibility for IL services,
  • referring eligible consumers to the IL trainer for specific IL services,
  • managing DBS case records for eligible consumers,
  • reviewing and approving individual training programs jointly developed by the IL trainer and the consumer,
  • incorporating approved individual training programs into each consumer's Independent Living Plan (ILP),
  • reviewing documentation of IL services provided by the IL trainer,
  • authorizing the purchase of recommended equipment and services,
  • documenting the purchase of equipment and services in each consumer's ILP, and
  • arranging or providing more complex services including (but not limited to) Braille instruction, orientation and mobility training within the consumer's local community, diabetes education and training, etc.

 

IL Skills Vendor Responsibilities

The IL skills vendor

  • completes the application assessment
  • provides the correct services as directed by the ILW and as described under the Scope of Services above,
  • conducts a comprehensive assessment,
  • submits the appropriate documentation for each type of service to the ILW for review and approval,
  • provides training in basic independent living skills as described in the comprehensive assessment and ILP,
  • periodically assesses each consumer's progress toward goals and timelines with the ILW,
  • submits appropriate recommendations for purchasing products and services for each consumer to the ILW, and
  • provides the ILW with a written report of each contact that includes details of the assessment or service provided and the outcome.

 

Initial Contact

The IL skills vendor must make the initial contact with a DBS consumer who is referred for independent living skills training within 15 working days of the referral.

Initial Contact and Application Assessment

All initial contacts and application assessments must be conducted individually and documented using the following forms:

 

Comprehensive Assessment

The IL skills vendor must contact a DBS consumer who is referred for a comprehensive assessment within 30 calendar days of the referral.

The vendor must document the comprehensive assessment on the DARS2954, Comprehensive Assessment for Independent Living Program. The recommendations section of the form must contain a summary of IL skills training and services that the vendor has identified for inclusion on the Independent Living Plan (ILP).

 

Independent Living Skills Training

After the ILW has developed the ILP, the IL skills vendor provides monthly training services as authorized by the ILW. The services are documented monthly using the DARS2891, Independent Living Services Progress Report. The monthly report must

  • detail the services provided to the consumer,
  • document the outcome of each service, and
  • include any recommendations for changes to the ILP.

5.3.4 Performance Measures

DBS considers the following questions in measuring vendor performance:

  • Did the IL skills vendor meet the consumer's independent living needs as requisitioned by the IL worker?
  • Has the IL skills vendor met DBS contract specifications?
  • Has the IL skills vendor performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • Was initial contact with DBS consumers accomplished in a timely manner after receipt of the referral?
  • Has the IL skills vendor adhered to DBS confidentiality standards?
  • Has the IL skills vendor submitted all required reports in accordance with DBS specifications or standards?
  • Has the IL skills vendor submitted fully completed invoices (including required attachments such as travel logs if applicable) no later than 35 calendar days following service completion?

5.4 Vocational Evaluations

5.4.1 Job Function

The vocational evaluation process is designed to determine the consumer's present and future vocational potential including evaluating the consumer's employment-related strengths and limitations.

5.4.2 Qualifications

Education, Training, and Experience

Vocational evaluators must have one of the following

  • Master's degree in Vocational Evaluation;
  • Master's degree in a related field (e.g., Psychology, Sociology, Education, etc.) and one year full-time experience as a vocational evaluator, preferably in vocational rehabilitation working with individuals who have visual disabilities and/or other disabilities;
  • Bachelor's degree in Vocational Evaluation and one year full-time experience as a vocational evaluator, preferably in vocational rehabilitation working with individuals who have visual disabilities and/or other disabilities; or
  • Bachelor's degree in a related field (e.g., Psychology, Sociology, Education, etc.) and two years full-time experience performing vocational evaluation services with individuals who have visual disabilities and/or other disabilities.

 

Certification Requirements

Each person who administers vocational tests, batteries, and/or related instruments that require certification must be certified by the appropriate entity. Examples of these tests or batteries include the Comprehensive Vocational Evaluation System (CVES), the McCarron Dial System (MDS), psychological tests, etc.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

 

Performance

Vocational evaluations must be performed by a vocational evaluator who meets the criteria described in this manual or a psychologist who is licensed and certified in the state of Texas.

 

Staff-to-Consumer Ratio

For the purpose of conducting vocational evaluations, the staff-to-consumer ratio must not exceed one staff member to three consumers (1:3). If the number of DBS consumers receiving vocational evaluation services at the same time is more than three but less than seven—in other words, a maximum of six consumers—a competent aide (technician) under the supervision of the vocational evaluator may be used to ensure the staff-to-consumer ratio does not exceed one to three (1:3).

5.4.3 Service Delivery

Scope of Services

Vocational evaluators provide the following services:

  • gather information about the consumer's personal, medical, psychological, social, education and work history;
  • evaluate the individual's vocational interests, skills, strengths, and limitations;
  • document and interpret test results;
  • make recommendations relating to the consumer's vocational goal; and
  • recommend training or educational needs, accommodations and other types of intervention to assist the individual in reaching their vocational goal.

 

Referral Form

Prior to each vocational evaluation, DBS will provide the vocational evaluator with a Referral for Vocational Evaluation form (or equivalent). The referral form will:

  • indicate why the consumer is being referred for vocational evaluation and
  • describe specific issues and/or questions that should be addressed in the evaluator's written report.

 

Developing the Consumer's Case History

Information about the consumer's case history shall be gathered through a review of available records and consumer self-reports and a summary of this information included in the vocational evaluation report. The consumer's case history should encompass:

  • personal information,
  • educational background,
  • employment history,
  • medical history,
  • social history,
  • psychological/emotional history and current stability,
  • daily living activities, and
  • independent living skills.

 

Information To Be Assessed

The evaluation process must address the consumer's employment assets and liabilities, potential for training, and overall work adjustment.

In the majority of instances at least two different techniques should be utilized to provide a more thorough evaluation. Vocational evaluators have the discretionary authority to determine which techniques should be used—in each case, however, the governing factor in selecting the most appropriate techniques must be the individual needs of the consumer.

The following areas shall be assessed.

  1. Cognitive abilities
    • learning ability including attention, concentration, comprehension, memory/ retention, creativity, and conceptualization;
    • communication skills and interaction with others;
    • ability to follow oral or written instructions;
    • work organization and planning; and
    • spatial concepts.
  2. Academic achievements (grade level) in reading, writing, spelling and mathematics.
  3. Physical abilities
    • fine motor abilities including bimanual dexterity, speed, coordination, and strength;
    • gross motor abilities including strength, balance, and coordination; and
    • stamina/physical tolerances and endurance.
  4. Sensory abilities (identify preferred learning style: visual, auditory, or tactile)
    • use of residual vision,
    • auditory processing and sound localization, and
    • tactile perception.
  5. Aptitudes and vocational interests/exploration
    • specific equipment and technical skills and
    • preferred vocational interests compared to abilities.
  6. Behavioral observations and work habits
    • general behaviors and work related behaviors;
    • self-image (pertaining to self and work);
    • appearance (grooming, hygiene, appropriate clothing for the work setting, etc.);
    • motivation and attitude toward work;
    • attendance and punctuality;
    • orientation to the work setting and travel within the work setting;
    • work stability (including attention to work despite environmental distractions);
    • work quality;
    • work productivity;
    • acceptance of supervision (accepting and responding to suggestions and corrections);
    • responsibility for materials and work;
    • adherence to workplace standards (employee policies, rules, schedules, etc.);
    • safety standards (understanding and adhering to safety standards);
    • impulse control (predictable behavior, adequate self-control, etc.);
    • stress tolerance;
    • flexibility;
    • persistence (following through on the work task to completion);
    • initiative (working independently);
    • job seeking skills; and
    • the consumer's potential to benefit from vocational rehabilitation services.

 

Test Instruments

All test instruments must be appropriate for use with the DBS target population including appropriate norms, adaptations, and accommodations.

Prior to the initiation of each contract, the vocational evaluator must provide DBS with a written list that:

  • identifies each test instrument to be used in evaluating consumers,
  • describes what each instrument is intended to measure, and
  • cross-references each instrument with the area(s) to be evaluated as outlined in the evaluator's contract.

The emphasis of the vocational evaluation is based on the outcome. Because the scope of each evaluation is governed by the consumer's individual need(s), there are no fixed guidelines regarding the number of days or hours per day required to complete an evaluation. Generally, an evaluation would be expected to take three to five days to gather all of the work characteristics outlined above.

The techniques used to establish and measure consumer work characteristics can generally be categorized as follows.

 

Standardized Tests

Standardized tests include tests that measure the consumer's academic achievement, cognitive abilities, aptitude, personality, vocational interests, sensory/motor skills, and independent living skills and compare the individual's performance with the performance of an appropriate sample population.

 

Psychological Tests

Psychological tests include any battery of tests or psychometric instruments that are administered and interpreted by a licensed psychologist or psychological associate to assess intelligence, aptitude, academic achievement, interests, personality, and level of adjustment.

 

Work Samples

Work samples provide a close simulation of an actual industrial task, business operation, or component of an occupational area.

 

Situational Assessments

A situational assessment is done at multiple work sites within a usual business or industry setting in the community. These community-based assessments provide an opportunity for the consumer to explore their ability to perform a variety of job tasks and help the consumer make informed choices about the type of work environment and job tasks they prefer. The evaluator's observations and the consumer's experiences are then used to determine the kind of job and needed supports that most closely match the consumer's preferences.

 

Vocational Evaluation Reports

Vocational evaluation reports must be submitted in the standard format required by DBS using a DARS2869, Vocational Evaluation Report.

Vocational evaluation reports are due within 15 working days after the evaluation is completed.

Each report must summarize

  1. the cumulative findings of the vocational evaluation; and
  2. the evaluator's outcome-oriented recommendations relating to the consumer's
    • vocational potential,
    • vocational rehabilitation needs, and
    • objective.

The direct service provider (i.e., vocational evaluator or psychologist) must sign the evaluation report.

The provider is not required to submit the DARS2869 if the provider performs a psychological evaluation in conjunction with the vocational evaluation. Reporting for this combination must be submitted using the traditional psychological evaluation format.

 

Cumulative Findings

The evaluator's written report must include:

  1. consumer demographic information,
  2. the reason for referral,
  3. background information (including visual impairment; other medical conditions; psychological, academic and work history; and social/emotional information),
  4. a complete list of all tests administered,
  5. interpretations of all test results (including a summary of strengths and limitations),
  6. the consumer's vocational interests,
  7. behavioral observations, and
  8. the evaluator's recommendations.

 

Outcome-Oriented Recommendations

Each report must include the evaluator's recommendations and must address the following.

  1. A response to each specific referral question.
  2. The consumer's optimal level of employment potential and job readiness.
  3. Specific occupations for the consumer to consider/explore.
  4. Job-related accommodations or adaptations, if needed.
  5. Any additional training or education needed for employment.
  6. Any additional evaluation needs such as medical or psychological evaluations, rehabilitation technology evaluations, etc.
  7. Consideration for supported employment services, if appropriate.
  8. Independent living needs, accommodations, and/or adaptations.
  9. Other vocational rehabilitation needs.

 

Pre-Staffing, Interim Staffing, and Post-Staffing

After the vocational evaluation has been completed, a post-staffing is required for each consumer receiving services. The meeting must include the evaluator, the consumer (and/or their representative if applicable), and the consumer's counselor or case manager.

If needed, pre-staffings and interim staffings may be held.

All staffings must be documented and placed in the consumer's file.

5.4.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's vocational evaluation needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • Were all evaluations conducted with a staff-to-consumer ratio of no more than one to three?
  • Did the provider schedule and provide the evaluation in a timely manner after receipt of the referral?
  • Were the appropriate evaluation tests and instruments used to complete each consumer's vocational evaluation?
  • Was a written vocational evaluation report (a) signed by the direct service provider and (b) submitted within 15 working days after completion of the evaluation?
  • Does each written report include the evaluator's (a) cumulative findings and (b) outcome-oriented recommendation?
  • Was a post-staffing accomplished and documented for each consumer?
  • Has the provider submitted all required consumer statistics worksheets to CPCSC (a) in accordance with the DBS-required schedule and (b) using the electronic format provided by DBS?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices (including required attachments such as travel logs if applicable) no later than 35 calendar days following service completion?

5.5 Vocational Adjustment

5.5.1 Job Function

Vocational adjustment training provides formal classroom training designed to increase a consumer's interpersonal skills relating to basic traits and attitudes. The focus of vocational adjustment training is work-related skills and successful employment.

5.5.2 Qualifications

Education, Training, and Experience

Vocational adjustment trainers must have one of the following:

  • a master's degree in rehabilitation, counseling and guidance, or psychology; or
  • a bachelor's degree in a related field (for example, education, sociology, liberal arts, etc.) and one year of full-time experience performing vocational adjustment or work adjustment services or similar duties in a rehabilitation agency or organization working with people who have visual disabilities and/or other disabilities; or
  • a combination of training and experience with a minimum of two years' full-time experience in the successful provision of services to people with disabilities. These services must be similar to those provided in vocational adjustment training.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

 

Performance

Reasonable flexibility to vary vocational adjustment services will be authorized in order to accommodate the specific needs of individual consumers.

 

Staff-to-Consumer Ratio

For the purpose of conducting vocational adjustment training, the staff-to-consumer ratio must not exceed one staff member to six consumers (1:6). In a group setting (a maximum of ten consumers per group), a competent aide under the supervision of the vocational adjustment trainer may be used if the number of DBS consumers receiving vocational adjustment training at the same time is more than six but not more than ten consumers.

5.5.3 Service Delivery

Scope of Services

Vocational adjustment training may be provided one-on-one or in a group setting, as determined by the trainer. Training is provided in a formal classroom environment and includes job-related skills such as:

  • social skills,
  • daily living skills,
  • effective communication,
  • grooming and hygiene,
  • problem solving,
  • goal setting,
  • time management,
  • financial management,
  • disability awareness,
  • self-concept,
  • self-motivation,
  • work traits and work ethics, and
  • conflict resolution.

 

Outcome—Social Skills

The consumer will demonstrate appropriate social behavior in selected settings on a routine basis.

 

Outcome—Daily Living Skills

The consumer will demonstrate the daily living skills (food preparation, homemaking, etc.) necessary to function independently.

 

Outcome—Effective Communication Skills

The consumer will demonstrate clear and open communication in multiple settings including authority figures, co-workers, and peers. Skill areas will include appropriate phone etiquette, face-to-face communication, and cooperative communication with an interactive group.

 

Outcome—Grooming and Hygiene

The consumer will demonstrate appropriate personal grooming and hygiene for a work environment.

 

Outcome—Problem Solving

The consumer will demonstrate appropriate solutions to pre-identified work-related barriers.

 

Outcome—Goal Setting

The consumer will demonstrate an understanding of realistic goals and objectives.

 

Outcome—Time Management

The consumer will demonstrate effective time scheduling including but not limited to: understanding the importance of punctuality, following attendance guidelines, meeting deadlines, and scheduling appointments appropriately.

 

Outcome—Financial Management

The consumer will demonstrate an understanding of basic budgeting, banking services, and the responsible use of credit.

 

Outcome—Disability Awareness

The consumer will demonstrate proficiency in explaining their disability and offering solutions to disability-related problems.

 

Outcome—Self-Concept

The consumer will demonstrate a clear understanding of their personal assets, skills, and abilities.

 

Outcome—Self-Motivation

The consumer will demonstrate a clear understanding of the concept, influence, and benefits of self-motivation.

 

Outcome—Work Traits and Work Ethics

The consumer will demonstrate appropriate work-related behaviors including acceptable attendance and tardiness records during vocational adjustment training, developing and maintaining productive interpersonal relationships with both co-workers and supervisors, recognition of "quality" work, and the ability to compete appropriately for work assignments, supervisory recognition, promotions, etc.

 

Outcome—Conflict Resolution

The consumer will demonstrate the ability to cope with and resolve work-related problems or conflicts in an appropriate manner.

 

Vocational Adjustment Training Reports

Vocational adjustment training reports must be submitted in the standard format required by DBS using a DARS2870, Vocational Adjustment Progress Report form.

Vocational adjustment training reports are due within 35 calendar days from the date training is completed.

5.5.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's vocational adjustment training needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • Were each of the desired minimum outcomes (a) demonstrated by the consumer after completing vocational adjustment training and (b) supported by written documentation in the consumer case file?
  • Was all vocational adjustment training conducted with a staff-to-consumer ratio of no more than one-to-six?
  • Were all training records and activity sheets for each consumer completed and signed by the direct service provider (the trainer who actually provided the training)?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices no later than 35 calendar days following service completion?

5.6 Work Adjustment

5.6.1 Job Function

Work adjustment trainers provide formal hands-on training for DBS consumers within the context of "real" work (training on work-related behaviors is provided in a work setting where the work performed by the consumer produces compensation for both the community rehabilitation program facility and the consumer).

5.6.2 Qualifications

Education, Training, and Experience

Work adjustment trainers must have one of the following:

  • a master's degree in rehabilitation, counseling and guidance, or psychology; or
  • a bachelor's degree in a related field (for example, education, sociology, liberal arts, etc.) and one year of full-time experience performing adjustment services or similar duties in a rehabilitation agency or organization working with individuals who have visual disabilities and/or other disabilities; or
  • a combination of training and experience with a minimum of two years' full time experience in the successful provision of services to people with disabilities. These services must be similar to those provided in vocational adjustment training.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

 

Performance

Reasonable flexibility to vary work adjustment services will be authorized in order to accommodate the specific needs of individual consumers.

 

Staff-to-Consumer Ratio

For the purpose of conducting work adjustment training, the staff-to-consumer ratio must not exceed one staff member to six consumers (1:6). A competent aide under the supervision of the work adjustment trainer may be used if the number of DBS consumers receiving work adjustment training at the same time is more than six but not more than ten consumers.

5.6.3 Service Delivery

Scope of Services

Work adjustment services are designed to assist consumers in the following areas.

  1. Address the consumer's work behaviors.
  2. Motivate the consumer to:
    • perform productive work,
    • be self-reliant,
    • accept supervision, and
    • interact appropriately with co-workers.
  3. Help the consumer develop:
    • work tolerance,
    • good work practices (including safety and speed), and
    • job-readiness skills based on community standards.

Work adjustment services may also include training in other job-related skills such as:

  • social skills,
  • daily living skills,
  • effective communication,
  • grooming and hygiene,
  • problem solving, and
  • goal setting.

 

Documenting Work Adjustment Training

DARS2955, Consumer Services Report: Work Adjustment Progress Report for individual consumers must be signed by the work adjustment trainer who conducted the training and submitted to the consumer's counselor or case manager upon completion of training.

5.6.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's work adjustment training needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • Was all work adjustment training conducted with a staff-to-consumer ratio of no more than one to six?
  • Were all training records and activity sheets for each consumer completed and signed by the direct service provider (the trainer who actually provided the training)?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices (including required attachments such as travel logs if applicable) within 35 calendar days following service completion?

5.7 Job Readiness Training

5.7.1 Job Function

Job readiness trainers provide complex, interrelated services designed primarily to help prepare individual consumers for job searches.

5.7.2 Qualifications

Education, Training, and Experience

Job readiness trainers must have:

  • a high school diploma or GED,
  • a varied and successful work history,
  • knowledge of employer expectations,
  • knowledge of the local job market,
  • the ability to demonstrate and teach effective job-seeking and job-retention skills, and
  • a minimum of one year experience in providing employment services to persons who have visual disabilities and/or other disabilities.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

5.7.3 Service Delivery

Scope of Services

Job readiness services may include:

  • personal/socialization skills training
  • résumé development,
  • job application training,
  • job seeking skills training,
  • interviewing skills training, and/or
  • job retention skills training.

 

Job Readiness Training Period

The extent of services required for individual consumers to complete job readiness training is based on each consumer's specific needs. It is anticipated that most DBS consumers will complete job readiness training in 20 hours or less.

 

Personal/Socialization Skills Training

Purpose—Personal/socialization skills services reinforce the proper socialization skills needed in the workplace.

Outcome—The consumer will understand the importance of:

  • personal grooming and hygiene,
  • dependability/reliability on the job,
  • employer expectations, and
  • communication skills.

 

Résumé Development

Purpose—Résumé development services are designed to assist the consumer in developing and completing an effective résumé.

Outcome—The consumer will understand the importance of and how to develop a résumé, vita, cover letter, and/or portfolio. The consumer will demonstrate the ability to:

  • collect the information necessary to develop their résumé, vita, cover letter, and/or portfolio;
  • discuss the information contained in the document(s) they have developed;
  • update the document(s) with current information; and
  • tailor the document(s) to the specific job(s) for which the consumer is applying.

Note: A copy of the consumer's completed résumé, vita, cover letter, and/or portfolio must be submitted to the consumer's counselor at the post-staffing.

 

Job Application Training

Purpose—Job application services are provided to assist and/or train the consumer in the skills needed to accurately complete a job application.

Outcome—The consumer will demonstrate the ability to:

  • develop a personal data sheet in the appropriate media (Braille, large print, electronic, etc.) to use in completing an application and/or cover letter;
  • use alternate techniques for completing a job application (using a reader, magnification products, using a computer to complete an on-line application, etc.); and
  • successfully complete a job application independently or, if necessary, with assistance.

Note: No less than three applications must be completed. A copy of each completed application must be submitted to the consumer's counselor at the post-staffing.

 

Job Seeking Skills Training

Purpose—Job seeking skills services are designed to assist the consumer in developing the skills needed to conduct an effective job search.

Outcome—The consumer will demonstrate the ability to:

  • develop a resource list containing the names of people and resources that can help the consumer get a job including, but not limited to: family, friends, past employers, co-workers, the local Texas Workforce Commission office, the yellow pages, want ads, etc.;
  • use appropriate skills to call a contact person or resource on their list, describe their skills and/or experience, and ask the contact person to assist them in finding a job (by asking about current job openings, requesting a letter of reference, obtaining permission to list the contact person as a reference on job applications, etc.);
  • use appropriate skills to develop job leads through the use of job postings, want ads, the local Texas Workforce Commission office, and other available resources; and
  • demonstrate the ability to research prospective employers and job positions based on the individual consumer's skills, interests, and experience.

Note: A copy of the consumer's resource list must be submitted to the consumer's counselor at the post-staffing.

 

Interviewing Skills Training

Purpose—Interviewing skills services reinforce essential skills and/or instruct the consumer in new skills necessary to help the consumer complete a successful interview.

Outcome—The consumer will demonstrate the skills needed to conduct a successful interview including the ability to:

  • research the potential employer's organization;
  • anticipate interview questions specific to the position for which the consumer will be applying;
  • prepare for the job interview using appropriate dress and personal grooming;
  • discuss, when necessary and appropriate, their disability and any required accommodations; and
  • use appropriate skills to complete a job interview.

Note: At the post-staffing, the trainer must provide the consumer's counselor or case manager with a written evaluation (critique) of three video/audio taped mock interviews and documentation of face-to-face discussions with the consumer regarding each of the three interviews. Discussion of each interview should include areas such as appearance, attentiveness, confidence, motivation, and communication skills. The trainer should make a video/audio copy of the three mock interviews available to the consumer upon request. The tapes may be destroyed after the consumer has been successfully placed in employment or upon counselor authorization.

 

Job Retention Skills Training

Purpose—Job retention skills help the consumer develop the skills and techniques necessary to maintain successful employment.

Outcome—The consumer will demonstrate the skills needed to maintain successful employment including the ability to:

  • fit in at a new job,
  • understand the importance of (and follow) punctuality and attendance guidelines,
  • determine the appropriate person to notify if the consumer is ill or running late,
  • determine the appropriate person to contact if the consumer has a question,
  • address work-related problems,
  • cope with (and benefit from) job-related errors and mistakes,
  • ask for a raise, and
  • apply for a promotion.

 

Initial and Interim Staffings

An initial staffing must be completed before services may be initiated.

The consumer (and/or their representative if applicable), the consumer's counselor or case manager, and the provider will conduct an initial staffing before training is initiated to ensure a complete understanding of the consumer's vocational goal.

During the initial staffing, a DARS2877, Initial Staffing Recommendations, form will be completed to detail the job readiness training needed by the individual consumer. The form shall be signed by the consumer, the consumer's counselor or case manager, and the provider.

If needed, interim staffings may be held.

All initial and interim staffings must be documented using a DARS2877 form and placed in the consumer's file.

 

Authorization for Training

Based on the results of the initial staffing, the consumer's counselor or case manager may approve from one to 20 hours of job readiness training.

 

Authorization for Additional Training

If the consumer requires more than 20 hours of training, an interim staffing must be completed to determine the consumer's progress and to document the status of their job readiness training.

If it is determined that additional training is appropriate, the consumer's counselor or case manager may request approval for up to ten additional hours of training through the regional director.

All requests for additional training must be approved by the regional director. Training beyond the first 25 hours, if any, must be approved through the supervisory chain of management to the DBS director of field services.

 

Post-Staffing

After job readiness training has been completed, a post-staffing is required for each consumer receiving services. The meeting must include the consumer (and/or their representative if applicable), the consumer's counselor or case manager, and the provider.

At the time of the post-staffing,

  • a DARS2878, Post-Staffing Evaluation, form will be completed to document the consumer's progress toward job readiness;
  • the DARS2878, Post-Staffing Evaluation, form shall be signed by the consumer, the consumer's counselor or case manager, and the provider;
  • the provider shall submit a copy of the video/audio interview tapes (if requested by the consumer's counselor or case manager); and
  • the provider must submit all required documentation as shown below.

The post-staffing process determines:

  1. Is the consumer job ready?
  2. What is the anticipated number of hours the consumer will work per week?
  3. Will the provider accept the referral of the consumer for job placement services?

If the provider accepts the job placement referral, a DARS2876, Job Placement Referral Acceptance, form must be completed and signed before the post-staffing process is concluded (for additional information, please see 5.8 Job Placement in this manual).

All staffings must be documented and placed in the consumer's file.

 

Documenting Services

Completion of job readiness training services requires the following documentation:

  • a fully completed DARS2878, Post-Staffing Evaluation form;
  • a copy of the consumer's completed résumé, vita, cover letter, and/or portfolio;
  • copies of at least three completed job applications;
  • a copy of the consumer's resource list; and
  • a written evaluation (critique) of three video/audio taped mock interviews including documentation of face-to-face discussions with the consumer regarding each of the three interviews.

5.7.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's job readiness training needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • For consumers participating in job application training:
    1. Was a data sheet developed for the consumer?
    2. Upon completion of training, was the consumer able to demonstrate the ability to use the data sheet and other prompts as needed to complete a job application?
  • For consumers participating in interviewing skills training:
    1. Were three mock interviews conducted and discussed with the consumer?
    2. Was a copy of a video or audio recording of the consumer's three mock interviews made available to the consumer upon completion of training?
    3. Upon completion of training, was the consumer able to demonstrate the skills needed to complete a successful interview?
  • For consumers participating in job-seeking skills training:
    1. Was a list of people and resources developed for the consumer to aid in his or her job search?
    2. Upon completion of training, was the consumer able to demonstrate the ability to research and develop leads?
  • For consumers participating in résumé development skills training:
    1. Was a complete and effective résumé developed for the consumer?
    2. Was the consumer provided with both a hard copy and an electronic copy of his or her résumé?
  • For consumers participating in preemployment training, was the provider available to assist the consumer during the consumer's orientation to the job site?
  • For consumers participating in job retention skills training:
    1. Were appropriate job retention skills and techniques identified with the consumer?
    2. Were each of the job retention skills and techniques discussed and reviewed with the consumer?
    3. Did the provider address problems identified during the consumer's training?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices (including required attachments such as travel logs if applicable) no later than 35 days following service completion?

5.8 Job Placement

5.8.1 Job Function

Job placement service providers assist consumers with employment-related services necessary for the consumer to secure and maintain acceptable employment.

5.8.2 Qualifications

Education, Training, and Experience

Job placement service providers must have:

  • a high school diploma or GED,
  • a varied and successful work history,
  • knowledge of employer expectations,
  • knowledge of the local job market, and
  • a minimum of one year experience in providing employment services to persons who have visual disabilities and/or other disabilities.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

A service authorization and/or purchase order must be completed at placement for the first payment and the second payment. Then, when all progress reports and payments are due, DBS will adjust dollar amounts as needed based on the check stub at the final billing.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For more information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.8.3 Service Delivery

Scope of Services

Job placement services include, but are not limited to, the following.

  1. Account building, employer contacts, and job analysis.
  2. Matching individual DBS consumers with appropriate employment opportunities.
  3. Job placement services for individual consumers including pre-employment orientation, support of newly-hired consumers for at least 90 days of employment, and; follow-up with the consumer and/or employer as appropriate.

 

Acceptable Employment

Acceptable employment is a position in an integrated employment setting at or above current minimum wage. Integrated employment is defined in federal regulations as:

"a setting typically found in the community in which applicants or eligible individuals interact with non-disabled individuals other than non-disabled individuals who are providing services to those applicants or eligible individuals."

 

Acceptable Job Placement

Acceptable job placement means acceptable employment of a DBS consumer in a meaningful job commensurate with the individual consumer's stated vocational goals in an integrated employment setting at a wage equal to or above current minimum wage for at least 90 days.

Acceptable job placement is limited to job placement in an integrated setting within an organization or business that is not owned, operated, controlled, or otherwise governed by the contract service provider.

 

Outcome—Job Placement

Job placement services are completed when the consumer:

  • has been referred to and hired by an acceptable employer,
  • is employed in a position consistent with the consumer's vocational goals,
  • is earning a wage equal to or above current minimum wage, and
  • has been successfully employed for at least 90 calendar days.

 

Referral Process

An initial staffing must be completed before job placement services may be initiated. The purpose of the initial staffing is to allow the consumer, the counselor, and the job placement provider an opportunity to meet and discuss the consumer's employment goals including:

  • the individual's vocational goal,
  • expectations for full-time or part-time employment, and
  • the anticipated number of hours to be worked each week.

All initial staffings must be documented using a DARS2876, Job Placement Referral Acceptance, form (see immediately below) and placed in the consumer's file.

 

Referral Acceptance

Following completion of the initial staffing, the job placement provider shall complete a DARS2876, Job Placement Referral Acceptance form.

The DARS2876 form documents the job placement provider's acceptance (or non-acceptance) of the referral for job placement services.

The DARS2876 form must be signed by both the counselor and the job placement provider.

 

Notification of Job Placement

The job placement provider is required to notify the consumer's counselor or case manager when the consumer is scheduled for an employment interview.

The job placement provider is required to submit a DARS2873, Initial Placement Report, form to the consumer's counselor or case manager when the consumer accepts a job offer.

 

Follow-Up Reports

On the 30th and 60th day of employment, the job placement provider must submit a written report to the consumer's counselor or case manager.

All post-employment follow up reports must be submitted in the standard format required by DBS using a DARS2875, Post-Employment Follow Up Report form.

The written report must include a brief narrative of the consumer's performance including:

  • any problems and/or issues associated with employment,
  • the employer's satisfaction with the consumer, and
  • the consumer's satisfaction with the employment.

The narrative should include any actions taken to resolve problems/issues and expected outcomes as a result of the actions. These actions may include but are not limited to:

  • re-evaluating the consumer's position and job duties,
  • determining if modifications are necessary,
  • recommending job coach services,
  • additional assistive technology and/or training, and
  • transportation issues

 

Documenting Job Placement

After the consumer has been successfully employed for at least 90 calendar days, the job placement provider is required to submit a fully completed and signed DARS2872, Job Placement Final Billing, form to the consumer's counselor or case manager verifying that the consumer has been employed for at least 90 days in a job that is consistent with the consumer's vocational goal.

The job placement provider's signature on the DARS2872 form is the provider's verification of the following minimum employment conditions:

  • The consumer and the employer are both satisfied.
  • The consumer's work is consistent with the consumer's abilities and interests.
  • The consumer has the necessary skills to perform the work in a satisfactory manner.
  • The work and the working conditions will not aggravate the consumer's disability and the consumer's disability will not jeopardize the health or safety of others.
  • The consumer's wages and working conditions conform to federal and state laws.
  • The employment is regular and reasonably permanent.
  • The consumer's wages are commensurate to wages of similar workers.

Note: A copy of the consumer's most recent paycheck or check stub must be attached to the provider's DARS2872, Job Placement Final Billing form. If the job placement provider is unable to obtain a copy of the consumer's most recent paycheck or check stub, a fee estimated to be the equivalent of one-week salary will be paid if the consumer's counselor or case manager documents verification of employment in the consumer's case file.

 

Verification of Employment

Upon receipt of the job placement provider's written statements, DBS will verify completion of job placement services by

  • contacting the consumer and/or employer, and
  • documenting the contact in the consumer's case record.

 

Social Security Administration/Vocational Rehabilitation (SSA/VR) Employment Network

For providers who are also employment networks as defined by the Social Security Administration, see 5.13 SSA/VR Ticket to Work Partnership Plus—EN Employment Advancement Payments.

5.8.4 Performance Measures

DBS considers the following questions in measuring provider performance:

  • Did the provider meet the consumer's job placement needs as requisitioned by the consumer's counselor or case manager?
  • Has the provider met DBS contract specifications?
  • Has the provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provides contract services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provides contract services to DBS consumers resigned during the contract period, did the provider inform CPCSC of the staff member's resignation no later than the employee's last day?
  • Did the provider make suitable employer contacts (contacts that could result in acceptable employment opportunities for DBS consumers)?
  • Did the provider notify the consumer's counselor or case manager in a timely manner when consumers (a) were scheduled for an employment interview or (b) accepted a job offer?
  • After 90 days of employment, did the provider submit a written statement to the consumer's counselor or case manager in a timely manner to verify job placement and provide all required information?
  • Has the provider adhered to DBS confidentiality standards?
  • Has the provider submitted all required reports in accordance with DBS specifications or standards?
  • Has the provider submitted fully completed invoices (including required attachments such as travel logs if applicable) no later than 35 calendar days following service completion?

5.9 Diabetes Self-Management – Education Services

5.9.1 Job Function

DBS educates consumers about diabetes self-management.

Diabetes self-management education services are used to:

  • assess the consumer's ability to independently manage the disease at home;
  • assess the consumer's ability to independently manage the disease in the workplace;
  • assess the consumer's ability to participate in intensive rehabilitation training for persons who are blind, such as the training sessions and mini-training sessions offered by DARS CCRC;
  • prepare a consumer to make informed choices about his or her diabetes; and
  • help the consumer develop the confidence and skills to implement his or her choices.

5.9.2 Qualifications

Diabetes self-management education services are provided by a service provider who instructs and counsels the consumer and family through individual and/or group skills training.

 

Education and Experience Requirement

A service provider is a health professional, who:

  • is licensed or registered, as required by his or her profession;
  • has completed basic academic requirements for his or her field; and
  • has practiced for at least one year.

A service provider for consumers must be a registered nurse (RN), registered dietician (RD), or certified diabetes educator (CDE). For RNs and RDs, DARS Contract Oversight and Support (COS) unit keeps a copy of the service provider's active license on file. For a CDE, COS keeps a copy of the service provider's current certification from the National Certification Board for Diabetes Education (NCBDE) or the American Association of Diabetes Educators (AADE) on file.

Through academic preparation, continuing education, or on-the-job training, the service provider will have developed:

  • a knowledge and understanding of diabetes and its management, including the nutritional and pharmaceutical aspects of care;
  • a knowledge and understanding of basic educational and behavioral science;
  • the additional skills necessary to work in a thorough and efficient manner, such as planning, organizing, communicating, cooperating, delegating, and working without direct supervision; and
  • a knowledge of the Texas Confidence Builders philosophy.

A service provider (CDE, RN, or RD) must have at least one year of paid experience providing diabetes education. RNs and RDs must have completed 15 hours of continuing education units (CEUs) on diabetes from an accredited agency within 12 months of the application date. A CDE must have completed 10 hours of CEUs on diabetes from an accredited agency within 12 months of the application date. The CEUs must be from an agency approved by the service provider's licensing or certifying body.

The service provider must send a copy documenting the CEUs to the diabetes program specialist (DPS).

The specialist:

  • retains a copy in the specialist's file; and
  • forwards a copy to the regional program support specialist (RPSS).

 

Technical Skills Requirement

A service provider must:

  • be able to assess a consumer's educational needs and clinical status;
  • offer group instruction and public speaking skills;
  • offer interactive teaching techniques for individuals and groups;
  • be able to communicate technical medical information at a level appropriate for the learner;
  • be able to create a positive and accepting learning environment;
  • be able to relate positively to all consumers;
  • believe in the capabilities and independence of people with disabilities;
  • have good verbal and written communication skills;
  • have basic computer skills, including word processing; and
  • have a private email address, which will not be given to non-approved staff members.

To determine a potential service provider's knowledge about diabetes and behavioral change, a diabetes program specialist may interview the potential provider during the initial contracting process and/or ask him or her to take a skills test.

 

Training Requirement

Before providing services to consumers, the service provider must either:

  • attend a Texas Confidence Builders training session conducted by the diabetes program specialist; or
  • attend an approved mini-training session, followed by the next available Texas Confidence Builders training.

Veteran service providers must attend Texas Confidence Builders training at least every two years.

Texas Conference Builder training is a 14-hour training led by the diabetes program specialist. The training iincludes a two-hour blindfold experience. The service provider is expected to attend the entire training. Exceptions must be approved by the diabetes program specialist in writing before the training begins.

At the discretion of the diabetes program specialist, service providers may also be required to attend additional periodic training seminars.

If travel is necessary in order to attend the required training, the service provider is responsible for paying all travel costs including transportation, food, and lodging.

5.9.3 Service Provider Authorization and Reimbursement

Diabetes self-management education services must not begin until a service authorization (SA) has been issued by DARS. It is the service provider's responsibility to check the accuracy of the SA before scheduling a visit with the consumer.

If the service provider is unable to schedule the visit within three calendar weeks, the service provider notifies the consumer's vocational rehabilitation counselor (VRC) or independent living worker (ILW).

Service providers must have written authorization before the service provider or the provider's employees provide diabetes self-management education services to consumers. DARS does not pay for diabetes self-management education services, if the services are provided before written authorization is received.

For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.9.4 Service Delivery

Scope of Services

Up to 15 hours of individual and group diabetes self-management education services can be approved, including skills training. Additional hours must be approved by the field director and discussed with the diabetes program specialist (DPS).

Self-management of diabetes is an important component of an education plan. The education plan must be customized for each consumer

  • age;
  • schedule;
  • physical activity;
  • eating patterns;
  • cultural factors;
  • personality; and
  • diabetes-related complications or other medical conditions (ADA, 2003e).

Diabetes self-management education services include:

  • an initial assessment (up to two hours);
  • skills training on diabetes self-management (up to 12 hours); and
  • a post training assessment (up to one hour).

Individual skills training on diabetes self-management is divided into short segments (ideally two-hour blocks) to reduce travel costs and ensure that the consumer maintains the physical and intellectual stamina needed to benefit from the skills training.

Group sessions (that is, sessions for two or more consumers at a time) can be cost effective. Service providers are encouraged to coordinate group skills training sessions when they will benefit the instruction process and better meet the needs of the consumer. Approval must be obtained from the referring case manager before skills training begins.

If group skills training sessions are conducted, the initial assessment and post training assessment must be conducted individually, so that a consumer’s health information and other concerns may be addressed privately.

Providers of diabetes education are reimbursed only for the time spent teaching consumers about diabetes.

Providers are not reimbursed for:

  • travel time;
  • planning time;
  • office interaction time; or
  • time spent completing and submitting the required paperwork.

Note: If diabetes self-management education services take more or less than the recommended amount of time (for instance, if an assessment takes more than two hours), the service provider: must document the exceptions to the recommended amount of time; and include the documentation in the report before DARS will consider payment.

The required documentation must be submitted within 35 calendar days of the date that any diabetes self-management education service is provided, including initial assessment, skills training, and post training assessment.

Service providers are strongly encouraged to call or email the consumer's vocational rehabilitation counselor (VRC) or independent living worker (ILW) immediately when situations arise that affect the consumer's health or ability to participate in skills training on diabetes self-management.

 

Assessing Diabetes Self-Management Education Service

The service provider ensures that the individualized education plan (including the initial assessment, instructional and skills training methods, and teaching materials) is appropriate for each consumer, based on the consumer's:

  • age;
  • type of diabetes (type I or II) and duration;
  • cultural influences; and
  • learning abilities.

 

The Initial Assessment

The initial assessment for each consumer must include the consumer's:

  • relevant medical history;
  • cultural influences;
  • health beliefs and attitudes;
  • diabetes knowledge;
  • self-management skills and behaviors;
  • readiness to learn;
  • cognitive ability;
  • physical limitations;
  • level of family support;
  • financial status; and
  • any employment issues related to diabetes.

As part of the initial assessment, the service provider recommends the specific skills training that the consumer may need.

The training may include information on:

  • the pathophysiology of diabetes (an overview);
  • nutrition;
  • exercise and activity;
  • blood glucose monitoring and use of monitoring results;
  • diabetes-related complications;
  • management of sick days;
  • medical treatment;
  • medication;
  • foot, skin, and dental care;
  • preconception care, pregnancy, and gestational diabetes;
  • insulin;
  • use of the health care system;
  • community resources;
  • stress and psychosocial adjustment;
  • goal setting; and
  • employment aspects and/or barriers related to diabetes.

 

Blood Glucose Meter

For the purpose of assessing consumers and providing them with skills training, service providers may use the talking blood glucose meter recommended by DBS. If the provider recommends using another talking meter, the diabetes program specialist must approve it before skills training occurs.

If DBS changes its recommendation on a talking blood glucose meter, the service provider has 90 calendar days after being notified about the change to obtain the new talking blood glucose meter.

The consumer’s vocational rehabilitation counselor (VCR) or independent living worker (ILW) is responsible for approving the purchase of the recommended equipment or supplies.

 

Skills Training for Diabetes Self-Management

The number of skills training hours recommended for individual diabetes self-management is based on:

  • the initial assessment; and
  • the topics covered that are related to the consumer’s vocational and independent living goals.

Skills training on diabetes self-management must include:

  • goals for behavioral change; and
  • participation in healthy lifestyle changes.

A copy of the current DARS diabetes education materials is provided to the consumer in his or her preferred medium (for example, large print, CD, and so on).

Other education materials, resources and referrals are documented on the required forms.

Diabetes self-management education is primarily intended to:

  • provide knowledge and skills training; and
  • help the consumer identify barriers, solve problems, and develop coping skills to achieve effective self-care and behavior change.

The initial assessment and subsequent skills training on diabetes self-management is based on the seven self-care behaviors identified by the American Association of Diabetes Educators.

The AADE’s seven self-care behaviors (known as AADE7) are:

  • healthy eating;
  • being active;
  • monitoring;
  • taking medications;
  • healthy coping;
  • problem solving; and
  • reducing risk.

 

Group Training

Skills training for diabetes self-management can be provided:

  • in a group of two or more consumers; or
  • as a combination of one-on-one and group training sessions.

In most cases, the training should not exceed 15 hours, total.

Individual skills training for diabetes self-management may be authorized, if group training cannot be scheduled in a timely manner.

The initial assessment and subsequent skills training are usually conducted in the consumer's home. If the skills training is conducted in a group and meets outside the consumer's home, the training and payment are different. Contact the DARS regional program support specialist (RPSS) for more information.

 

Post-Training Assessment

Post-training (follow-up) assessments are conducted by the service provider at least one month (30 calendar days) after the skills training is completed.

As part of the post training assessment, the service provider:

  • reviews the skills training provided; and
  • reinforces the behavioral changes.

If a post-training assessment is provided before one month (30 calendar days) after the skills training is completed, the service provider must secure approval from the referring case manager.

5.9.5 Documentation of Diabetes Self-Management Education Services

Documentation of Initial Assessments

The service provider's initial assessment and other findings for each consumer are documented using:

  • DARS2888, Diabetes Self-Management Education Assessment; and
  • DARS2901, Diabetes Pre- and Post-assessment.

 

Documentation of Skills Training and Equipment

Service providers must document each two-hour skills training session provided to each consumer using DARS2884, Diabetes Self-Management Educator Notes.

If the diabetes self-management education services for a consumer include providing the consumer with a talking blood glucose meter or other diabetes equipment, the service provider's responsibilities include:

  • coordinating receipt of the equipment with the local field office that purchased the service;
  • submitting DARS2889, Diabetes Self-Management Education Services - Adaptive Diabetes Equipment Receipt;
  • delivering the equipment or supplies to the consumer;
  • obtaining the consumer's signature on DARS2889 to acknowledge receipt of equipment or supplies;
  • filling out the manufacturer's warranty card by mail or online; and
  • documenting on DARS2889 that the warrantee card has been submitted.

Note: When submitting paperwork electronically, the service provider may enter the phrase "signature on file" to represent the consumer's signature. The service providers must keep the original signature on file and be able to provide it on request.

 

Documentation of Post Training (Follow-Up) Assessment

The one-hour post-training (follow-up) assessment must be documented using:

  • DARS2900, Diabetes Self-Management Education Posttraining Assessment; and
  • DARS2901, Diabetes Pre- and Post-Assessment.

 

Exceptions

When speaking by phone or in person to a vocational rehabilitation counselor (VRC), independent living worker (ILW), or rehabilitation assistant (RA) about differences in service delivery, including changes in a service authorization or no-show request, the provider's call or in-person discussion is documented in an email between all parties.

Exceptions, such as being unable to complete skills training or provide a blood glucose meter other than the currently approved talking glucose meter, require written approval from the diabetes program specialist (DPS).

5.9.6 Performance Measures

To adequately measure the performance of a service provider, DBS staff members ask the following questions:

  • Did the service provider meet the consumer's need for diabetes education, as requisitioned by the consumer's counselor or case manager?
  • Has the service provider met the specifications of the DARS contract?
  • Has the service provider performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member of the service provider who provides contract services to consumers was hired during the contract period, did the service provider submit a staff information sheet to the regional program support specialist (RPSS) within 10 calendar days of the staff member's hire? Did the staff member meet the qualifications and was the staff member approved before his or her first visit with a consumer?
  • If a staff member of a service provider who provides contract services to consumers resigned during the contract period, did the service provider inform the RPSS about the staff member's resignation no later than the employee's last day?
  • Has the service provider adhered to DARS confidentiality standards?
  • Has the service provider submitted all required reports in accordance with DARS specifications or standards?
  • Has the service provider submitted accurate, completed invoices (including required attachments such as appropriate forms and travel logs if applicable) no later than 35 calendar days after services were completed?

5.10 Aides and Drivers

5.10.1 Aides

  1. Aides (such as vocational evaluation aides, work adjustment aides, etc.) must be qualified and must work under the direct supervision of an authorized service provider.
  2. Aides are required to have one year of actual work experience in vocational areas directly related to vocational evaluation, personal-social adjustment, and/or work adjustment. At the discretion of the Department of Assistive and Rehabilitative Services-Division for Blind Services (DBS), post-secondary education in a related field may be substituted for actual work experience.
  3. Aides must be able to follow instructions and establish rapport with DBS consumers.
  4. Aides are not authorized to sign reports.

5.10.2 Drivers

Any person who transports DBS consumers must have a valid Class B or Class C driver's license, appropriate liability insurance, and a good driving record.

5.11 Orientation and Mobility Training

5.11.1 Job Function of O&M Providers

Orientation and Mobility (O&M) providers offer complex, interrelated services designed to promote independent travel skills for people who are blind or visually impaired.

O&M training prepares DBS consumers to travel independently with competence and confidence. Orientation is the process of using the available senses to establish one's position and relationship within the environment. Mobility is the ability to travel in the environment with the help of an established tool (including white canes, dog guides, and electronic travel aids).

5.11.2 Qualifications and Requirements of O&M Providers

Education, Training, and Experience

The O&M contractor must ensure that each person approved to provide O&M services to DBS consumers under its contract meets one of the following requirements.

  1. The provider is certified by either the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) or the National Blindness Professional Certification Board (NBPCB).
  2. The provider is not certified at the start of the contract, but he or she
    • has a degree in O&M from an accredited college or university with an established O&M training curriculum and will be certified within one year of the contract date by ACVREP or NBPCB; or
    • has at least two years' full-time work experience teaching O&M skills for an entity DBS recognizes, such as a rehabilitation center, VA hospital, or educational system; and also
      • has three professional references indicating the person's ability to teach O&M skills to blind or visually impaired people, and
      • will be certified within one year of the contract date by ACVREP or NBPCB.

To continue contracting services with DBS, all O&M service providers under the contract must maintain ACVREP or NBPCB certification.

 

Required Texas Confidence Builders Training

(Revised 4/07, 11/10)

In addition to meeting the education, training, and experience requirements described above, all prospective O&M providers must successfully complete the DBS Texas Confidence Builders Training before becoming providers. Texas Confidence Builders Training is offered quarterly in Austin and is a two- or three-day training program. Each provider is responsible for all costs related to training attendance.

Additional training may be provided by the DBS O&M consultant if necessary or requested by the O&M provider.

 

Recommended Blindfold Travel Activities

(Revised 11/10)

O&M providers are encouraged to complete a minimum of 20 hours of blindfold travel per fiscal year and submit a detailed statement describing each travel activity completed and the number of hours achieved per activity. This ensures that an O&M provider

  • practices his or her own independent travel skills,
  • provides effective role modeling, and
  • promotes independent travel as a confidence-building tool for consumers.

Examples of acceptable blindfold travel activities include traveling around a city block, sidewalk travel on an L-shaped sidewalk route, traveling to the grocery store, and exploring a new neighborhood.

DBS recommends that the O&M providers create a report like the sample O&M Provider's Independent Travel Activity Report. Each O&M provider sends a copy of the provider's blindfold travel activity statement to

  • the consumer procurement manager for DBS, and
  • the designated O&M consultant for DBS.

 

Internship Requirements

O&M providers using interns to work with DBS consumers must

  • have an established contract with DBS to provide O&M services to consumers;
  • submit to DBS a DARS2871, Contract Service Provider Staff Information Sheet for all interns (indicate intern under position title);
  • observe a minimum of 12 lessons during the internship. Document these observations on a DARS2922, Weekly Internship Observation: Orientation and Mobility and submit it monthly to the regional program support specialist; and
  • submit a DARS2923, Orientation and Mobility: Internship Performance Evaluation to the regional program support manager within 35 days of the completion of the internship.

O&M interns must

  • attend Texas Confidence Builders Training in Austin or other approved training with the DBS O&M consultant before working with DBS consumers. The intern is responsible for all expenses related to the training;
  • be supervised by an approved DBS-certified O&M provider for the duration of the internship;
  • be observed by a DBS-certified O&M provider for a minimum of 12 lessons during the internship;
  • follow all DBS standards; and
  • sign and forward reports to the supervising O&M provider for his or her approval.

 

Provider Authorization

Providers must not provide services without a service authorization and/or purchase order. DBS does not reimburse for costs or pay for services provided before the date on the service authorization and/or purchase order.

5.11.3 Service Delivery

Scope of Services

Orientation and Mobility (O&M) services include:

  • an initial assessment of the consumer's O&M skills (if any) including strengths, challenges, and existing competency levels;
  • a review of the assessment results and training recommendations with the consumer; and
  • O&M skills training as agreed upon by the consumer, the counselor or case manager, and the O&M provider.

 

Provider Objectivity

The O&M provider must remain impartial and objective.

 

Referral Information

Before contacting the consumer, the O&M provider receives referral information from the consumer's DBS counselor or case manager. The DBS counselor or case manager fills out known information on 2897, O&M Referral. The O&M referral form helps the O&M provider prepare and plan before contacting the consumer.

 

Initial Assessment

Assessments may be conducted using the consumer's functional vision, which is an opportunity for consumers to recognize that their vision may not meet all their travel needs.

The initial assessment includes an evaluation of the consumer's orientation and mobility skills in multiple situations, which may include:

  • the consumer's home and immediate surrounding area;
  • public areas, such as a church, park, or college campus;
  • commercial areas, such as a bank, store, or mall;
  • transit systems, such as paratransit or taxis (if available);
  • local buses and similar public transportation (if available);
  • rural areas (if applicable);
  • residential areas (those with light vehicle and foot traffic and some stop signs);
  • small business areas (those with heavier traffic and simple traffic lights);
  • downtown areas (those with heavy vehicle and foot traffic and complex traffic lights);
  • commercial transportation systems, such as buses, trains, and airplanes (if applicable); and
  • travel using low-vision devices (if applicable).

 

Post-Assessment Discussion

Following the initial assessment, the O&M provider reviews the results with the consumer and answers any questions that he or she may have about the recommended training. A meeting with the consumer, counselor or case manager, and O&M provider is strongly recommended, so that all parties can agree on the overall O&M training plan.

 

Documenting the Initial Assessment

Initial assessment reports must be submitted using 2894, Consumer Services Report: O&M Assessment.

The assessment report includes:

  • the O&M provider's observations and comments;
  • recommendations for O&M skills training in each of the areas included in the initial assessment;
  • the number of recommended training hours for each area;
  • the total number of training hours being recommended;
  • the anticipated period (beginning and ending dates) for recommended training;
  • the consumer's acceptance or rejection of the training recommendations;
  • the height of the rigid cane that is most appropriate for the consumer (using the measurement between the consumer's chin and nose when standing up); and
  • a description of all travel aids the consumer uses or would benefit from using.

 

Training Authorization

After submitting the 2894, Consumer Services Report: O&M Assessment, the O&M provider must contact the consumer's counselor or case manager to discuss the initial assessment and get authorization to provide training services.

The discussion includes:

  • the provider's recommendations for training (if any), including the:
    • orientation and mobility skills needed;
    • proposed completion date; and
    • number of training hours authorized by the consumer's counselor or case manager;
  • anticipated delays in services, if any;
  • special considerations or extended direct training dates, if any;
  • the consumer's readiness to begin nonvisual O&M skills training; and
  • the consumer's understanding of O&M skills training and its potential benefits.

 

Monthly Progress Reports

After receiving authorization to provide training services, the O&M provider must document each consumer's monthly training progress using 2896, Consumer Services Report: O&M Training.

Monthly progress reports must be submitted within 30 days of the end of each calendar month until the consumer's O&M services are completed or services are no longer recommended by the consumer's counselor or case manager.

Each consumer's monthly progress report must include:

  • the number of training hours provided in each training area;
  • a detailed narrative of each skill area addressed during the reporting period and the training location for each lesson. Training locations include:
    • home (indoors and outdoors);
    • public areas (bank, church, doctor's office, and so on);
    • commercial areas (grocery store, mall, and so on);
    • transit systems (public transportation, paratransit, taxi, and so on);
    • rural areas;
    • residential areas (light traffic and stop signs);
    • small business areas (heavier traffic and simple traffic lights);
    • downtown areas (heavy traffic and complex lights); and
    • commercial travel (trains, planes, and so on);
  • a detailed explanation of anticipated training for the upcoming month;
  • an explanation of deviations from assessment recommendations, if any; and
  • a detailed narrative of cumulative progress if training is complete.

 

Expectations of Training

All O&M training services for DBS consumers must be conducted using nonvisual (blindfold) techniques and a rigid (nonfolding) cane. All exceptions must be discussed with the consumer's counselor or case manager before training services are begun, and must be fully documented in the provider's required reports. Approval must be fully documented by the case manager in the case notes.

O&M providers discuss the benefits of nonvisual training with each consumer. Role modeling and peer support for nonvisual training are encouraged.

With prior authorization from the consumer's counselor or case manager, visual training may be provided after nonvisual training is completed to transfer skills.

Note: The provider must get written authorization (by email or handwritten note) before providing visual training of any kind. DBS does not reimburse visual training without prior written authorization.

 

Group Training

DBS encourages O&M providers to coordinate group trainings (of up to three consumers) when it will benefit the instruction process and better meet the needs of the consumers. However, the O&M provider must get approval from each consumer's counselor or case manager before providing group training.

 

Travel Aids

The counselor or case manager provides one rigid, long, white cane for each consumer for O&M assessment and training, to be distributed by the O&M provider or vocational rehabilitation teacher (VRT).

If a consumer has a guide dog, the consumer is assessed by the O&M provider to ensure that the consumer has proficient cane skills. O&M training can occur with either a cane or guide dog.

The DBS provider must include observations and recommendations of cane skills in the initial assessment. Recommended hours for training must be inclusive of the consumer's travel needs, regardless of the mobility tool (dog or cane). Additional hours are not requested for training with a guide dog.

In addition, O&M providers give cane-purchasing information to each consumer. Consumers are responsible for acquiring all replacement canes, cane tips, back-up canes, and so on.

O&M providers may recommend additional travel aids or other items to the consumer's counselor or case manager; but the decision to purchase additional items rests solely with the counselor or case manager.

DBS does not reimburse O&M providers for any items provided to a DBS consumer by the provider.

DBS encourages consumers to contact the school from which they obtained their guide dog for further assessments and direct training for the guide dog, if needed.

 

Providing Services

Orientation and mobility training may not exceed the extent of services (type of training and total number of training hours) authorized by the consumer's counselor or case manager.

An O&M provider cannot have more than 25 DBS consumers in active training at any time, and must keep counselors and case managers informed of the total number of consumers in active training. Any consumer who has been provided services, from assessment through completion, is considered to be in active training. The capacity for 25 consumers in active training was determined to allow for group lessons. Priority for training is determined on a case-by-case basis in consultation with each consumer's counselor or case manager.

O&M providers cannot provide more than six hours of training on any given day, even if multiple consumers are served in that day. Lessons are approximately two hours long. Without prior authorization from a counselor, an individual consumer must not receive more than four hours or less than two hours of O&M instruction on any given day.

Consistent and frequent scheduling is recommended to maximize consumer learning. Daily O&M training is considered best practice. For VR consumers, one two-hour lesson a week is the minimum training allowable.

For IL consumers, the IL worker authorizes two to three hours for the initial assessment. If training is recommended, the IL worker allows no more than five hours of training per month. If additional training time is needed (because of safety-related concerns, secondary disability, or a specific consumer request), the O&M provider sends a written request to the IL worker, including the number of additional hours requested and the reason more hours are needed. Requests for additional training are made as part of the initial assessment, when possible.

Transporting consumers does not count toward training time. O&M providers are not reimbursed for time spent in the car, even when a consumer is present.

The O&M provider must notify the consumer's counselor or case manager within 24 hours about all:

  • no-shows, cancellations, or rescheduled appointments;
  • issues, concerns, or circumstances that might impact or delay planned services; and
  • issues that might delay the completion of services.

O&M providers must get written approval from the counselor or case manager before deviating from any of these standards during training (even when based on an individual consumer's needs).

 

If Services Are Interrupted

If training cannot be completed as planned or if services are postponed indefinitely because of unexpected circumstances, the O&M service provider must notify the consumer's counselor or case manager within 24 hours.

5.11.4 Performance Measures

DBS considers the following questions when measuring an O&M provider's performance:

  • Did the provider meet the consumer's orientation and mobility skills training needs as described by the consumer's counselor or case manager?
  • Has the provider met all contract specifications?
  • Has the provider provided all services in a professional manner in accordance with the requirements detailed in this manual?
  • If a staff member who provided services to DBS consumers was hired during the contract period, did the provider submit a staff information sheet to CPCSC before the new employee provided services to DBS consumers?
  • If a staff member who provided services to DBS consumers resigned during the contract period, did the provider notify CPCSC no later than the employee's last day?
  • Has the provider followed DBS confidentiality standards?
  • Has the provider submitted all reports required by DBS specifications and standards?
  • Has the provider submitted complete invoices (including required attachments such as travel logs, if applicable) no later than 35 days after service completion?

5.12 Standards for Supported Employment Services

5.12.1 Supported Employment (SE) Services Overview

Supported Employment (SE) is a "place then train" model, which is a two-part process:

  1. place a consumer with the most significant disabilities in a competitive job, and then
  2. provide training and support directly related to the job.

Unlike the traditional VR model, which provides job readiness and other training activities to prepare a consumer for employment, this model is more appropriate for consumers with the most significant disabilities. Problems transferring knowledge from an artificial training situation to a real job are eliminated, because the focus is on finding the best job match and providing training for that particular job.

For consumers to be eligible for SE services, they must meet the DARS definition of most significant disability as determined by the VRC. Consumers must

  • have three or more limited functional capacities, and
  • require Extended Services and supports to be successfully employed.

Consumers with the most significant disabilities who have any of the following challenges or needs are appropriate for SE services:

  • Competitive integrated employment for the consumer has not occurred or has been interrupted or intermittent.
  • Consumer has not benefited from traditional VR services.
  • Consumer requires considerable assistance competing in the open job market.
  • Consumer has had difficulty finding an appropriate job match.
  • Consumer can maintain competitive integrated employment with necessary supports in place.
  • Consumer will need another person, organization, or other resource to provide the Extended Services and supports after the VR-funded services end.

SE services enable consumers with the most significant disabilities to enter competitive integrated employment by providing

  • individualized assistance finding the most appropriate job match, and
  • ongoing support within the work environment.

SE services are for consumers who have been unable to find or maintain employment through traditional VR approaches and training programs.

Consumers in SE need assistance to

  • compete in the open market,
  • meet potential employers, and
  • receive ongoing supports to maintain a job.

Often, these consumers have been

  • excluded from community services;
  • institutionalized; or
  • in segregated work programs such as sheltered workshops for long periods.

An SE service provider seeks the best possible match between a consumer's skills, interests, abilities, and support needs and the employer's unmet business needs. In many cases, these jobs need to be carved out or created for a good job match to be made. The employment specialist or job skills trainer addresses any barriers to employment the consumer might have and may provide short-term support, while natural supports (such as peers or co-workers) are being arranged to meet the consumer's long-term needs. An employer who hires a consumer in SE should provide training for the consumer just as he or she would for other new employees, with help and support from the DARS counselor and the employment specialist. The SE specialist should ensure that adequate support is provided to the consumer by the job skills trainer on a routine basis. The SE specialist works in coordination with the VRC throughout the SE process to ensure the best possible employment outcome for the consumer.

5.12.2 Supported Employment (SE) Definitions

Benchmarks

Benchmarks are specific employment outcomes for which payments are made to the provider during the course of the SE process. 

These include

  • Benchmark 1A: Supported Employment Assessment (SEA);
  • Benchmark 1B: Supported Employment Services Plan (SESP) Part 1;
  • Benchmark 2: Job Placement and SESP Part 2;
  • Benchmark 3: Four-Week Job Maintenance;
  • Benchmark 4: Eight-Week Job Maintenance;
  • Benchmark 5: Job Stability; and
  • Benchmark 6: Service Closure.

 

Competitive Integrated Employment

Competitive integrated employment is work in the competitive labor market

  • that is performed full-time (or the maximum number of hours possible) in an integrated work setting; and
  • for which the person is compensated at or above the minimum wage, but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities.

 

Discovery Process

The discovery process entails collecting information about the consumer through interviews and observations of his or her abilities in multiple settings on multiple occasions. Research indicates that the discovery process may take as many as 20 to 30 hours per consumer (The Job Developer's Handbook, Griffin, Hammis, Geary).

 

Extended Services and Supports

Extended Services and supports may be needed to maintain the employment outcome after a consumer's VR case has been closed. Extended Services and supports involve either on-or off-site monitoring (as requested by the consumer or legal representative) for as long as needed to ensure the consumer's job stability. These services are provided and funded by sources other than DARS and may include the employer. Both natural supports and paid supports, including Long-Term Supports and Services provided by other state and federal programs, can be used to facilitate Extended Services.

Long-Term Supports and Services (LTSS) are Extended Services and supports available through the Texas Department of Aging and Disability Services (DADS) or Texas Deoartment of State Health Services (DSHS). The counselor should get a copy of the individual service plan from the LTSS case manager or service coordinator. The service "Supported Employment," detailing the provider and the amount of units authorized, should be included on the plan when LTSS are used to provide any of the Extended Services and supports a consumer may need to maintain employment before the counselor closes the case. For assistance in coordinating with DADS, contact the program specialist for benefits and DADS.

 

Integrated Work Setting

An integrated work setting provides an environment where consumers with disabilities regularly interact with nondisabled employees and/or the general public.

 

Most Significant Disability

Most Significant Disability is a term used to describe a consumer who

  • can be expected to require multiple VR services for an extended period of time; and
  • has a severe physical or mental impairment that seriously limits three or more functional capacities such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills as they relate to achieving and/or maintaining competitive integrated employment.

 

Natural Supports

Natural supports are supports that exist naturally in a workplace and the community.

These are supports provided to an employee from supervisors and co-workers, such as mentoring, friendship, socializing at breaks or after work, providing feedback on job performance, or learning a new skill together. Friends, family, or volunteers who support the consumer's success with maintaining employment can also provide natural supports outside of the worksite. Examples of supports provided away from the worksite could include providing transportation, reporting of earned income to the Social Security Administration (SSA), providing feedback on attire and hygiene, or assisting with medication management. When natural support resources are not available, paid supports not funded by DARS can be used to ensure that a consumer maintains long-term employment.

 

Negotiable Employment Conditions

Negotiable Employment Conditions are preferences for working conditions and the things that a consumer would like the placement provider to consider when looking for suitable employment.

 

Non-negotiable Employment Conditions

Non-negotiable Employment Conditions are those conditions that a consumer and counselor have indicated must or must not be present in an employment placement. The placement provider must always assure these conditions are met when looking for an employment placement for the consumer.

Examples of non-negotiable conditions include, but are not limited to:

  • The job needs to be on a particular bus route.
  • The consumer must earn a certain dollar amount per hour.
  • The consumer must work at least 15 but no more than 20 hours per week.
  • The job must not require duties the consumer is unwilling to perform.
  • The worksite must allow for an onsite job coach.

 

Person-Centered Planning

In person-centered planning, the process and the products are owned and controlled by the person (consumer). The process creates a comprehensive portrait of who the person is and what the person wants to do with his or her life. It brings together all the people who are important to the person, including family members, friends, neighbors, support workers, and other professionals. This team identifies the skills and abilities that can help the person achieve his or her goals for competitive integrated employment, independent living, continuing education, and full inclusion in the community. The team also identifies areas in which the person may need assistance and support and decides how it can best meet those needs.

 

Quality Criteria

Quality Criteria are points of reference used by DARS counselors and VR staff when they review provider documentation and services rendered to determine whether certain conditions and outcomes were achieved by the consumer and/or the provider. Quality Criteria, which must be effectively documented on the appropriate DARS reporting forms, must be met before the DARS counselor may authorize payment to the provider.

 

Significant Disability

Significant Disability is a term used to describe a consumer who

  • can be expected to require multiple VR services for an extended period of time; and
  • has a severe physical or mental impairment that seriously limits one or more functional capacities such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills as they relate to achieving and/or maintaining competitive integrated employment.

 

Social Security Administration/Vocational Rehabilitation (SSA/VR) Employment Network

For providers who are also employment networks as defined by the SSA, see 5.13 SSA/VR Ticket to Work Partnership Plus—EN Employment Advancement Payments.

 

Supported Employment

Supported Employment (SE) is competitive employment in an integrated work setting, consistent with the consumer's

  • strengths,
  • resources,
  • priorities,
  • concerns,
  • abilities,
  • capabilities,
  • interests, and
  • informed choice.

SE services are appropriate for the consumer with the most significant disabilities who meets all the following criteria:

  • The consumer has not worked or has worked only intermittently, in competitive integrated employment.
  • The consumer has been determined eligible for VR services based on a comprehensive assessment, including consideration of SE as an employment outcome.
  • The consumer needs Extended Services to maintain employment following successful VR closure.
  • The consumer can maintain competitive integrated employment with necessary supports.

This definition includes transitional employment for people with the most significant disabilities caused by chronic mental illness.

 

Transitional Employment for Consumers with Chronic Mental Illness

Transitional employment is a series of temporary job placements in competitive integrated employment in integrated work settings for consumers who need support services on or off the worksite. In transitional employment, the SE services must include continuing job placements until a suitable employment outcome is achieved.

5.12.3 Staff Qualifications

Before services are provided to DARS consumers, the staff person overseeing the provider's SE services (director, program manager, supervisor, etc.) must complete the Provider Orientation and Training, which is provided by the DARS contract manager and the regional program support specialist for DBS. The training focuses on the SE outcome-based standards, forms, contract compliance, and Quality Criteria. After being trained, this person must provide similar training to the staff members who will provide direct services to DARS consumers, as well as document the training in the personnel files.

 

Employment Specialist

An employment specialist must meet the education and experience qualifications in one of the following three options:

Option 1

  • a bachelor's degree in rehabilitation, business, marketing, or related human services; and
  • one year's documented experience in a professional or personal setting routinely working with people with disabilities.

Option 2

  • an associate's degree in rehabilitation, business, marketing, or related human services; and
  • two years' documented experience in a professional or personal setting routinely working with people with disabilities.

Option 3

  • a high school diploma or GED; and
  • three years' documented experience in a professional or personal setting routinely working with people with disabilities.

 

UNT Certification Required of Employment Specialists

(Revised 08/12, 12/14)

In addition to the Provider Orientation and Training described above, employment specialists must have the UNT Certification for SE specialists. Completion of certification must be documented in the contract files.

All employment specialists are encouraged to attend at least one continuing education class per year to increase their skills in placing consumers in the job market.

 

Job Skills Trainer

A job skills trainer must have

  • a high school diploma or GED, and
  • one year of experience of working with people who have disabilities.

In addition to the Provider Orientation and Training described above, job skills trainers must complete the UNT Certification for job skills trainer. Completion of training must be documented in the contract files. It is a best practice for the job skills trainer to work under the direction of the SE specialist.

5.12.4 Provider Responsibilities

All provider staff members must:

  • maintain effective and professional consumer and employer relations;
  • provide services as outlined in the Standards Manual;
  • document consumer-related and employment-related information and services as outlined in the Standards Manual;
  • achieve all Quality Criteria for services rendered; and
  • maintain effective verbal and written communications with DARS counselors, employers, and consumers.

DARS counselors are responsible for overseeing services provided to consumers. If the above general standards are not being met, the DARS Community Rehabilitation Provider (CRP) specialist or the DBS regional program support specialist reviews staff concerns and may require that the provider develop an action plan to address them. Continued failure to meet standards could result in adverse action against the provider.

5.12.5 Supported Employment (SE) Process

The following general rules apply to the SE process.

The supported employment (SE) provider must be contracted by DARS and must receive a written authorization for services from the DARS counselor before providing the SE services.

Job placement must be in an organization or a business that is not owned, operated, controlled, or governed by the community rehabilitation program (CRP) providing the SE service. CRPs that are state agencies or state universities are exempt from this requirement.

Job placement is complete when the consumer is placed and has completed five consecutive calendar days on the job in accordance with the job matches indicated on the SESP Part 1.

The provider must submit required documentation of provided services along with an invoice. The DARS counselor verifies that services were delivered and completed. The counselor reviews the documentation to ensure that all Quality Criteria have been achieved.

The DARS counselor may return incomplete documentation to be completed before authorizing payment.

If the consumer wants to change his or her targeted job tasks, negotiable employment conditions, or non-negotiable employment conditions at any point in the process, the SESP Part 1 must be revised in an additional SESP Part 1 meeting.

If the consumer loses his or her job at any point in the process, the consumer's progress within the benchmark is discontinued until the consumer becomes re-employed. Benchmark progress continues when the consumer becomes employed in a new position, and the SESP Part 2 is revised to reflect the new position.

If the consumer loses his or her job and requires placement in a new job, the counselor, the consumer, and the SE provider meet to:

  • discuss the reasons the consumer lost the job;
  • review the SESP Part 1, creating a new SESP Part 1 if needed; and
  • determine the plan for gaining another placement.

Any gap in employment greater than eight weeks results in a new employment period. Therefore, the consumer must complete a minimum of 30 cumulative calendar days of employment in the new job before employment is considered to be stable. The 30 days do not have to be consecutive, and there is no time limit within which they must be completed.

If the consumer changes jobs between Benchmarks 3 and 4, or Benchmarks 4 and 5, a minimum of 30 calendar days of employment in the new job is required before employment is considered to be stable. The 30 days do not have to be consecutive, and there is no time limit within which they must be completed.

The consumer must be meeting the expectations of the employer, and the Extended Services and supports must be identified on the current DARS1616, Job Stability or Service Closure Justification Summary, before the counselor can consider the consumer to be stable in the job.

A payment for each benchmark is made only once to an SE provider, even if the consumer loses a job after the completion of a benchmark and continues to receive services with that same SE provider. If the consumer chooses a new SE provider, the new SE provider and the DARS counselor negotiate the benchmark at which the consumer begins, and the benchmark may be purchased a second time from a new SE provider.

The SE outcome-based system is a comprehensive service package that may encompass a variety of services traditionally purchased separately. Therefore, the following vocational rehabilitation services cannot be purchased when a consumer is receiving SE services:

  • Vocational Assessment
  • Job Readiness
  • Job Placement
  • On-the-Job Training
  • Vocational Adjustment training
  • Work Adjustment Training
  • Personal Adjustment Training
  • Job Coaching

5.12.6 Benchmark 1A: Discovery, Supported Employment Assessment, Review Meeting, and Supported Employment Services Plan 1

Service Description

 

Benchmark 1A: Discovery, Supported Employment Assessment (SEA), and the Review Meeting

 

Discovery

If a consumer has a supported employment (SE) goal, discovery is conducted by the employment specialist. While there is no set standard for how much time a provider spends with a consumer during discovery, research suggests that providers should spend as many as 20 to 30 hours on the discovery process to observe the consumer's abilities, challenges, and resources, as well as to collect information from professional and nonprofessional supports in the consumer's life. The process includes exploring options related to wages, employment outcomes, and self-employment outcomes; including interests, capabilities, preferences, ongoing support needs; and Extended Services and supports required at and away from the job site that are necessary for employment success.

Discovery activities include:

  • exploring options related to wages and employment outcomes;
  • identifying options for Extended Services and supports that will be used for successful employment;
  • observing the consumer's work skills and behaviors at home and in the community environment and/or touring with the consumer in current or potential work environments;
  • collecting personal and employer reference information;
  • assessing the consumer's learning style and needs for adaptive technology, accommodations, and on-site supports; and
  • assessing the consumer's strengths, challenges, and transferable skills from previous job placements.

Supported Employment Assessment (SEA)

The discovery process enables the provider to gather information necessary to answer all the questions on the DARS1612, Supported Employment Assessment. The report must describe the consumer so that someone reading the report has an accurate understanding of who the consumer is and the consumer's employment goals. DARS recommends that the person-centered planning process be used when collecting information for the SEA.

The SEA must focus on the consumer's:

  • support needs that may be necessary for successful employment, including self-employment;
  • interests, skills, and functional abilities related to daily living, employment, and recreation; and
  • support needs that family, friends, and professionals provide to help the consumer maintain a quality life at home and in the community (for example, financial assistance, room and board, supervision for safety, and transportation).

The SEA must be submitted to the DARS counselor at least one week before the SEA review meeting. The DARS counselor reviews the SEA in accordance with the Quality Criteria. If the Quality Criteria are not achieved, the SEA is returned to the provider so the needed information can be added before the SEA review meeting.

SEA Review Meeting

The SEA review meeting is a meeting with the DARS counselor, consumer, and employment specialist following the completion of the discovery process and SEA. This meeting may happen in conjunction with Benchmark 1B. The SEA review meeting includes a discussion of SE, determines what employment outcome, if any, will be pursued, and identifies the type of documentation needed next. SEA information and recommendations are used to develop the DARS1614, Supported Employment Services Plan—Part 2.

Required Documentation

The SEA DARS1612, Supported Employment Assessment is required documentation and must:

  • include supporting documentation to determine support-needs tier for SE in the planning meeting;
  • provide enough information to determine one or more appropriate job matches, or to support the consumer's pursuit of a self-employment outcome;
  • identify specific support needs and/or interventions;
  • demonstrate that interests, assets, and abilities in work and nonwork areas were explored, identified, and appropriately summarized to enable the employment specialist to market the consumer to potential employers or to enable the pursuit of a self-employment outcome; and
  • be signed by the employment specialist who actually performed the discovery work with the consumer and completed the SEA form.

See Quality Criteria for the SEA.

Outcome

Benchmark 1A is complete when the DARS1612, Supported Employment Assessment, has been completed by the employment specialist and approved by the DARS counselor.

Payment

Payment for Benchmark 1A (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves:

  • the DARS1612, Supported Employment Assessment;
  • completion of the SEA meeting; and
  • an invoice.

Benchmark 1B: Supported Employment Services Plan (SESP) Part 1

Supported Employment Services Plan (SESP) Part 1

Benchmark

The SESP Part 1 is completed after the SEA and the SEA review meeting.

SESP Part 1 (DARS1613, Supported Employment Services Plan—Part 1) must be completed during an SESP Part 1 meeting and signed by all parties at the conclusion of the meeting. The SESP meetings are planning with the consumer, counselor, and provider. They should be held in person to allow all parties to participate in the discussion. The provider should not bring a completed DARS1613 to the meeting or complete the DARS1613 after conclusion of the meeting. The DARS counselor or designee will complete the DARS 1613 while the provider is facilitating the planning meeting to ensure that all input is captured correctly on the SE service plan. The completed DARS1613 should be signed by all parties at the conclusion of the meeting.

The SESP Part 1 (DARS1613) is developed and implemented with the consumer leading or assisted by team members. It identifies interests, preferences, and skills related to setting the long-term placement goal. Both the DARS counselor and the SE provider ensure that group discussions during SESP Part 1 include recommendations and strategies outlined in the SEA. The SESP Part 1 meeting typically is one to two hours long and is facilitated by the SE provider.

The SESP Part 1 identifies:

  • members of the SESP team;
  • consumer preferences and/or interests;
  • consumer assets and/or abilities;
  • negotiable and non-negotiable employment conditions;
  • potential Extended Services and support needs of the consumer;
  • targeted job tasks the consumer can perform or potentially perform; and
  • potential employers.

Team Members

Members of the consumer's SESP team must include:

  • the consumer;
  • the consumer's representative, if any;
  • the SE services provider; and
  • the DARS counselor.

The team may include other significant people whom the consumer wants to invite and who may potentially help achieve successful employment for the consumer or be a long-term support for the consumer. Significant people may include:

  • teachers;
  • case managers;
  • neighbors;
  • counselors;
  • siblings;
  • friends;
  • business owners; and/or
  • church members.

The team maintains ongoing communication throughout the process to ensure that SE outcomes are achieved.

Team members can help to:

  • identify a possible placement;
  • provide short- and long-term supports (including long-term Extended Services) to ensure employment success; and
  • motivate the consumer.

Preferences and Interests

Preferences and interests are specific types of work or activities in which the person would like to engage. Examples are:

  • Working in an office
  • Working with children
  • Teaching others
  • Working with computers

Preferences and interests can also be stated in negative terms (for example, "no fast food restaurant employment"). Information must be consistent with the SEA. Although the final job placement does not have to include all the listed preferences and interests, they should be prioritized during the meeting.

Assets and Abilities

Assets and abilities are the skills and traits the consumer offers a potential employer.

These may include:

  • personality traits;
  • interests;
  • skills; and
  • talents.

Information must be consistent with the SEA.

Employment Conditions

Employment conditions are characteristics that are important to the consumer and relevant to his or her support needs with respect to employment.

Conditions include:

  • environmental considerations (for example, indoors, outdoors, or crowded);
  • learning and training considerations;
  • safety issues;
  • transportation;
  • work hours (number of hours, shift, days);
  • specific anticipated support needs (for example, medications, toileting, redirecting); and
  • social and/or communication considerations.

SESP information must be consistent with information provided in the SEA.

The SESP Part 1 identifies which employment conditions are "negotiable" and "non-negotiable" as identified by the consumer and others. Employment conditions must be written in measureable terms so that each person has a clear understanding of the needs to be addressed. The placement must meet all non-negotiable employment conditions and the majority (50 percent or more) of the negotiable employment conditions listed in the SESP Part l.

Potential Extended Services and Support Needs of the Consumer

Extended Services and supports (sometimes referred to as long-term supports or services) may involve either on-site or off-site monitoring or delivery of services necessary for the consumer to maintain employment after DARS case closure. The Extended Services and supports are provided for as long as the consumer needs them and as long as the consumer or legal representative requests them.

Extended Services and supports identified must be consistent with the SEA and are updated throughout the consumer's employment.

Some examples of Extended Services and supports include:

  • job performance monitoring;
  • job skill training (short-term) for new job tasks added to job duties or to improve performance;
  • setting up compensatory strategies;
  • earned income reporting to the Social Security Administration;
  • services such as medication management, attendant care, and counseling;
  • business venture supports such as bookkeeping, marketing, and managing data or inventories; and
  • transportation.

Frequency of Extended Services and supports can be daily, weekly, monthly, or as identified.

Extended Services and supports are rendered and funded by sources other than DARS. Sources may include Social Security Employment Networks, Social Security Plan for Acheiving Self Support (PASS), property essential to self-support (PESS), or Impairment Related Work Expense (IRWE), Medicaid Waiver, parents, family, friends, churches, and nonprofits.

Possible resources for Extended Services and supports must be identified as part of the SESP Part 1 and updated throughout the process. When all other resources to pay for Extended Services and supports have been exhausted, a provider may offer to provide the supports on a fee-for-service basis. Such supports may be funded through a Plan to Achieve Self-Support (PASS) or Impairment Related Work Expense (IRWE), or they may be paid by the consumer or family. The cost of these supports must be disclosed to the consumer, the consumer must agree to that fee as part of the SESP Part 1 process, and the fee must be added to the consumer's Individualized Educational Plan (IEP). The community rehabilitation program provider will not attempt to collect any fees from the consumer or his or her family for services provided before DARS case closure.

Targeted Job Tasks

Targeted job tasks identified by the team are tasks the consumer can currently or potentially perform.

Information must be consistent with the:

  • SEA;
  • employment conditions; and
  • the consumer's preferences and/or interests.

Job tasks are not the same as job titles. Job titles are titles given to a group of duties (for example, administrative assistant), and job tasks describe specific activities (for example, filing, greeting customers, stocking shelves). Vague descriptions such as "kitchen helper" are not acceptable.

Potential Employers

Potential employers are specific employers or industries in the consumer's preferred or desired geographical boundaries where the identified job tasks might be performed. The list should be prioritized. If a member of the SESP Part 1 team has a potential job lead or contact, that information should be included.

Required Documentation

The DARS1613, Supported Employment Services Plan—Part 1 is required and must include:

  • preferences and/or interests;
  • assets and/or abilities;
  • employment conditions;
  • potential extended services and support needs;
  • targeted job tasks;
  • potential employers; and
  • the signatures of:
    • the consumer (or the signature of the consumer's legal representative);
    • the employment specialist; and
    • the counselor.

See Quality Criteria for SESP Part 1.

Outcome

Benchmark 1B is complete when the DARS1613, Supported Employment Services Plan—Part 1 (SESP Part 1) has been completed by the Supported Employment provider, signed by the appropriate parties, and approved by the DARS counselor.

The DARS1613 indicates whether the provider is eligible for any Employment Premium Services payments.

Payment

Payment for Benchmark 1B is made upon receipt of a completed, accurate, and signed DARS1613, Supported Employment Services Plan—Part 1, and invoice.

5.12.7 Benchmark 2: Job Placement and SESP Part 2

Service Description

Job Placement

Job placement is complete when the consumer has begun work (completed at least one workday) in a job consistent with job matches identified in the SESP Part 1.

The job does not have to be an exact match from the employer list or job task list. However, the job match must meet identified non-negotiable conditions to be considered an acceptable job.

Activities related to obtaining a job placement may include

  • writing résumés and proposals to assist in placement;
  • contacting employers from target lists and developing consumer jobs;
  • performing job analysis;
  • reviewing job match information;
  • assisting the consumer with job applications, pre-employment forms, practice interviews, and pre-employment testing or physicals;
  • accompanying consumer to interviews and company visits;
  • assisting the employer with Work Opportunity Tax Credit;
  • developing the consumer's transportation plan;
  • training the consumer on how to travel to and from the job; and
  • evaluating the job placement to collect information needed to complete the SESP Part 2.

 

SESP Part 2

The SESP Part 2 (DARS1614, Supported Employment Support Plan—Part 2) is a written report that acts as a "blueprint" of the placement and short- and long-term training and/or supports needs of the consumer. It includes the following job details:

  • employer's name,
  • employer's address,
  • employer's phone number,
  • date consumer began paid employment,
  • job title or position,
  • number of hours worked per week,
  • hourly wage,
  • supervisor name,
  • supervisor phone number,
  • essential work duties of the job and needed accommodations,
  • episodic work duties of the job and needed accommodations,
  • physical and environmental demands and needed accommodations,
  • analysis of work culture and any training or support issues,
  • description of initial and ongoing training provided by the employer and needed accommodations, and
  • consumer's support plan.

 

Required Documentation

The SESP Part 2 (DARS1614, Supported Employment Services Plan—Part 2) is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the job duties the consumer will be performing, the work culture, and any short- or long-term employment. The form must include the signatures of the consumer (or legally authorized representative) and the direct SE services provider.

See Quality Criteria for SESP Part 2.

 

Outcome

Benchmark 2 is complete when the following has been completed by the provider and approved by the DARS counselor:

  • SESP Part 2 (DARS1614, Supported Employment Services Plan—Part 2), documenting that the consumer has begun working and completed five cumulative calendar days of employment in a job that
    • is in an integrated work setting,
    • is compensated at or above the minimum wage but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities,
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • meets at least one targeted job task established in the consumer's SESP Part 1.

 

Payment

Payment for Benchmark 2 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the

  • DARS1614, Supported Employment Support Plan—Part 2; and
  • an invoice.

5.12.8 Benchmark 3: Four-Week Job Maintenance

Service Description

Intensive on- and off-job site supports are provided to help the consumer adjust to the demands of the integrated work environment. 

Activities may include

  • orienting and training the consumer in work-related tasks;
  • job skills training at the job site;
  • training or consulting with employers, co-workers, or advocates to maximize natural supports;
  • transportation training;
  • meetings with managers and supervisors to gain input and plan training;
  • problem resolution meetings with company personnel or support systems to ensure job retention; and
  • training in work-related tasks or behaviors to ensure job retention (for example, grooming or anger management).

 

Required Documentation

The DARS1615, Supported Employment Support Summary is required and should be written in positive, clear, descriptive English. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1615, Supported Employment Support Summary must

  • verify that the consumer has been working for four weeks (28 days) cumulatively;
  • verify that the consumer maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions; and
    • meets at least one targeted job task established in the consumer's SESP Part 1;
  • verify that the provider interacted with the consumer at or away from the job site in accordance with the support plan defined in SESP Part 2;
  • describe how specific support needs identified in the SESP Part 2 are being addressed; and
  • explain how emerging support needs are being met.

The form must include signatures of the consumer (or consumer's legally authorized representative) and the direct SE provider.

See Quality Criteria for Four-Week Job Maintenance.

 

Outcome

Benchmark 3 is complete when the consumer has

  • maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions,
    • meets at least one targeted job task,
    • is in an integrated work setting,
    • is compensated at or above the minimum wage but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities, and
    • matches the employment goal and targeted job tasks established in the consumer's SESP Part 1;
  • worked successfully for four weeks (28 days) cumulatively;
  • received the support services defined in the SESP Part 2; and
  • had new and emerging support needs addressed as needed.

If transitional employment for consumers with chronic mental illness is specified in the SESP Part 1, the benchmark is four weeks (28 days) cumulatively of employment, but not necessarily at the same job. Additionally the SE provider responds to any support-need changes identified by the consumer and/or the employer.

 

Payment

Payment for Benchmark 3 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

  • the DARS1615, Supported Employment Support Summary; and
  • an invoice.

5.12.9 Benchmark 4: Eight-Week Job Maintenance

Service Description

On- and off-job site supports are provided to help the consumer adjust to integrated work environment demands. 

Services may include

  • job skills training at the job site;
  • training or consulting with employers, co-workers, or advocates to maximize natural supports;
  • transportation training;
  • meetings with managers and supervisors to gain input and plan training;
  • problem-resolution meetings with company personnel or support systems to ensure job retention; and
  • training in work-related tasks or behaviors to ensure job retention (for example, grooming or anger management).

 

Required Documentation

The DARS1615, Supported Employment Support Summary is required and should be written in positive, clear, descriptive English. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1615, Supported Employment Support Summary must

  • verify that the consumer has been working for 8 weeks (56 days) cumulatively;
  • verify that the consumer maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • meets at least one targeted job task listed in the SESP Part 1;
  • verify that the provider interacted with the consumer as defined in the SESP Part 2 at or away from the job site during the time between the 4-week and 8-week benchmarks,
  • describe how specific support needs identified in the SESP Parts 1 and 2 have been addressed; and
  • explain how emerging support needs are being met.

The form must include signatures of the consumer, consumer's representative (if any), and the direct SE provider.

See Quality Criteria for Eight-Week Job Maintenance.

 

Outcome

Benchmark 4 is complete when the consumer has

  • maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • matches the employment goal and targeted job tasks established in the consumer's SESP Part 1;
    • is in an integrated work setting;
    • is compensated at or above the minimum wage but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities;
  • worked successfully for 8 weeks (56 days) cumulatively;
  • received the support services defined in the SESP Part 2; and
  • had new and emerging support needs addressed.

If transitional employment is specified in the SESP for a consumer with chronic mental illness, the benchmark is 8 weeks (56 days) of employment, but not necessarily at the same job. Additionally, the SE provider is responsive to any support-need changes identified by the consumer and/or the employer.

 

Payment

Payment for Benchmark 4 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

  • the DARS1615, Supported Employment Support Summary report; and
  • an invoice. 

5.12.10 Benchmark 5: Job Stability

Service Definition

The SE provider monitors the supports set up during Benchmark 3 and Benchmark 4 as outlined in the SESP Part 2 to ensure that the consumer is able to maintain successful long-term employment. The employme[nt specialist and/or job skills trainer should have a minimum of two contacts per month with the consumer and/or the employer or person providing natural supports. The employment specialist and/or job skills trainer should not be providing any direct service to the consumer during the 60-day period between job stability and service closure. If at any time, the employment specialist or job skills trainer must provide direct services to the consumer, stability has not been achieved, and the 60-day period starts over.

Note: If the consumer changes jobs between Benchmarks 4 and 5, a minimum of 30 cumulative calendars days of employment in the new job is required before job stability can be established.

 

Required Documentation

The DARS1616, Job Stability or Service Closure Justification Summary is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1616, Job Stability or Service Justification Summary must verify that

  • the consumer maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • meets at least one targeted job task listed in the SESP Part 1;
  • the consumer has worked a minimum of 8 weeks (56 days) cumulatively (Note: the consumer may need more than 8 weeks before he or she achieves Benchmark 5: Job Stability);
  • if the consumer has begun a new job during Benchmark 3 or 4, 30 days in the new job must be worked before the case is considered stable for the achievement of Benchmark 5;
  • the consumer is able to perform expected job duties;
  • the supervisor reports satisfaction with consumer's job performance;
  • the consumer and the consumer's representative, if any, are satisfied with the job and work environment;
  • necessary modifications and/or accommodations have been made at the worksite;
  • the consumer has reliable transportation to and from work, and a back-up transportation plan;
  • Extended Services and support needs are in place; and
  • other SESP-specified supports are present and functional.

The form must be signed by the consumer (or legally authorized representative) and the direct SE provider.

See Quality Criteria for Job Stability.

 

Outcome

Benchmark 5 is complete when

  • the consumer has worked a minimum of 8 weeks (56 days) cumulatively (Note: the consumer may need more than 8 weeks before he or she achieves Benchmark 5: Job Stability. If the consumer has begun a new job during Benchmark 3 or 4, 30 days in the new job must be worked before the case is considered stable for the achievement of Benchmark 5);
  • SE services have been provided;
  • the consumer has maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions,
    • meets at least one targeted job task established in the consumer's SESP Part 1,
    • is in an integrated work setting, and
    • is compensated at or above the minimum wage but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities;
  • the consumer has available the necessary supports defined in the SESP Part 2;
  • support needs have leveled off, and transition to Extended Services provided by and/or funded by sources other than DARS (for example, SE provider, family, MHMR, or other natural supports) is possible; and
  • the following people are satisfied:
    • the consumer,
    • the employer,
    • any representative,
    • the SE provider(s), and
    • the DARS counselor.

During the 60-day transition period between job stability and service closure, the DARS counselor may purchase only VR services that

  • are necessary to support the job placement and stability, and
  • the SE provider would not normally be expected to provide.

Examples of services that could be purchased include

  • replacement of prosthetic and orthotic devices,
  • maintenance of equipment, or
  • counseling and guidance to family members to support the consumer's job stability.

 

Payment

Payment for Benchmark 5 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the

  • DARS1616, Job Stability or Service Closure Justification Summary; and
  • an invoice. 

5.12.11 Benchmark 6: Service Closure

Service Description

The SE provider has successfully placed the consumer in a job consistent with jobs and employment conditions identified in the SESP Part 1, and the consumer has worked at least 90 days. Supports have been established as outlined in the SESP Part 2 to ensure successful placement, and monitoring of supports is the only service that the SE provider has performed for at least 60 days.

 

Required Documentation

The DARS1616, Job Stability or Service Closure Justification Summary is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

The DARS1616 must verify that the

  • consumer maintained employment that
    • is in an integrated work setting,
    • is compensated at or above the minimum wage but not less than the customary or usual wage paid by the employer for the same or similar work performed by people who do not have disabilities,
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • meets at least one targeted job task listed in the SESP Part 1;
  • consumer has maintained suitable SE for 60 days or longer after job stability was reached;
  • consumer has maintained the employment outcome for 90 days or longer;
  • consumer is able to perform the expected job duties;
  • supervisor reports satisfaction with the consumer's job performance;
  • consumer and the consumer's representative, if any, are satisfied with the job and work environment;
  • necessary modifications and/or accommodations have been made at the worksite;
  • consumer has reliable transportation to and from work, and a backup transportation plan;
  • Extended Services and supports are in place; and
  • other supports specified in the SESP Part 2 are present and functional.

The form must include signatures of the consumer (or legally authorized representative) and the direct SE services provider.

See Quality Criteria for Service Closure.

 

Outcome

Benchmark 6 is complete when

  • the consumer has achieved an employment outcome that is consistent with the consumer's
    • strengths,
    • resources,
    • priorities,
    • concerns,
    • abilities,
    • capabilities,
    • interests, and
    • informed choice;
  • the consumer has maintained employment that
    • meets all non-negotiable employment conditions,
    • meets 50 percent or more negotiable employment conditions, and
    • meets at least one targeted job task listed in the consumer's SESP Part 1;
  • the consumer has maintained suitable SE for 60 days or longer after job stability was reached;
  • the consumer has maintained the employment outcome for 90 days or longer;
  • the consumer is being compensated at or above the minimum wage, but not less than the customary or usual wage paid by the employer for the same or similar work performed by a person who does not have a disability;
  • there is evidence that the needed support systems including those in the SESP Part 2 are in place and working; and
  • the consumer, consumer's representative, if any, and the DARS counselor
    • consider the employment outcome satisfactory,
    • are satisfied with the supports, and
    • agree that the consumer is performing well on the job.

 

Payment

Payment for Benchmark 6 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the DARS1616, Job Stability or Service Closure Justification Summary.

5.12.12 Employment Premium Services

Service Overview:

A DARS counselor may purchase an optional Employment Premium Service(s) for a consumer. The consumer must meet the requirements to be eligible for the Employment Premium Service, and the provider must receive a PO that authorizes the Employment Premium Service. An Employment Premium Service payment is paid only once, and it is paid when the consumer achieves the required criteria. For Bundled Services such as Job Placement and SE, all benchmarks must have been completed prior to payment of any invoice for an Employment Premium Service. The form(s) and invoice will be returned to the provider if incomplete. When returned, notification of issues related to the incomplete form(s) and/or invoice will be provided and the provider must resubmit for payment.

Service Descriptions/Scopes:

Criminal Background Premium- For a consumer’s case to be eligible for the Criminal Background Premium, DARS must have a Criminal Background Check (CBC) on file that indicates the consumer has

  • a felony criminal conviction, or
  • a guilty plea with deferred adjudication for a felony criminal offense, or
  • a no contest plea with deferred adjudication for a felony criminal offense.

The employment services provider is eligible for the Criminal Background Premium when the consumer gains employment that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Services Plan—Part 1, including the Criminal Background Premium. The Criminal Background Premium must also be authorized by a PO.

The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report is submitted confirming the consumer has otherwise achieved the requirements for Basic or Enhanced Job Placement Service Benchmark C or Benchmark 6 in SE services.

Deaf Services Premium- The employment services provider is eligible for the Deaf Services Premium when a consumer communicates using manual sign and the job placement specialist or SE specialist providing services to consumers is proficient with sign language skills. The job placement specialist or SE specialist must prove proficiency in sign language by evidence of either holding a Board of Interpreters for the Deaf (BEI) certification, a Registry of Interpreters for the Deaf (RID) certification, or a Speech Language Pathologist (SLP) rating of intermediate plus. The employment services provider is eligible for the DEAF Service Premium when the consumer gains employment that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Service Plan—Part 1 including the Deaf Services Premium. The Deaf Services Premium must also be authorized by a PO. The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 or DARS1613 is submitted confirming the consumer

  • meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report and Benchmark Status Report or DARS1613 Supported Employment Service Plan—Part 1;
  • has otherwise achieved the requirements for Basic or Enhanced Job Placement Service Benchmark C or Benchmark 6 in SE services; and
  • proof of the job placement specialist or SE specialist maintains a Board of Interpreters for the Deaf (BEI) certification, or a Registry of Interpreters for the Deaf (RID) certification or a SLP rating of intermediate plus (copy of certification must be provided with invoice).

Livable Wage Premium- The employment services provider is eligible for the Livable Wage Premium when a consumer gains employment in a job that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Services Plan—Part 1 and the consumer earns a gross hourly wage of $16 per hour for more than 20 hours per week. The employment services provider is eligible for Livable Wage Premium when indicated on the DARS1833 or DARS 1613 and the Livable Wage Premium is authorized by a PO. Proof of the consumer’s earnings and average hours worked per week must be submitted such as an itemized pay stub with the invoice. The premium payment is made only once at the conclusion of the achievement of the employment service. 

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 or DARS1613 is submitted confirming the consumer

  • meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Services Plan—Part 1;
  • has a job that earns $16 per hour for more than 20 hours per week with a copy of an itemized pay stub submitted for proof; and
  • has otherwise achieved the requirements for Basic or Enhanced Job Placement Service Benchmark C or SE Benchmark 6.

Professional Placement Premium- The employment services provider is eligible for the Professional Placement Premium when a consumer gains employment in a job that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report and the position requires the completion of at least a bachelor's degree. This requirement must be stated in the employee's job description or job posting. The Professional Placement Premium must be indicated on the DARS1833 and the Professional Placement Premium must be authorized by a PO. The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 is submitted confirming that the consumer

  • meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Services Plan—Part 1;
  • has a job that requires at least a bachelor's degree (copy of the job description or job posting must be submitted as proof); and
  • has otherwise achieved the requirements for Basic or Enhanced Job Placement Service Benchmark C or SE Benchmark 6.

5.13 Social Security Administration/Vocational Rehabilitation (SSA/VR) Ticket to Work Partnership Plus—EN Employment Advancement Payments

5.13.1 Overview

Under the Social Security Administration's Ticket to Work Partnership Plus Program, DARS and Employment Networks (ENs), as defined by the Social Security Administration (SSA), partner to provide a seamless system of service delivery that supports a consumer who receives either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) payments in his or her efforts toward achieving and maintaining self-supporting employment. DARS provides vocational rehabilitation services, including Job Placement or Supported Employment, if appropriate, and, after VR case closure, an EN provides ongoing job supports and services to ensure that the consumer maintains and has opportunities to advance in employment.

In order for an EN to partner with DARS under the Ticket to Work Partnership Plus option, the consumer's Ticket cannot be assigned to an EN while VR services are being provided.

DARS offers incentive payments called EN Employment Advancement Payments to DARS community rehabilitation program (CRP) providers under the following circumstances:

  • the CRP is an approved EN with the SSA;
  • DARS purchased job placement (JP) or supported employment (SE) services from the CRP-EN for the consumer, and those services resulted in a successful case closure;
  • following VR case closure, the consumer assigns his or her Ticket to the CRP-EN; or
  • for SE only, the CRP must be identified on the DARS1616, Job Stability or Service Closure Justification Summary as one of the primary providers who will help the consumer achieve an identified long-term support need.

Note: DARS EN Employment Advancement Payments are not available to the CRP-EN when the consumer decides to assign the Ticket to an EN other than the CRP-EN. In keeping with informed choice, DARS will provide the consumer with a list of all available ENs at VR case closure.

If a CRP-EN is the holder of the consumer's Ticket assignment, the Ticket must be unassigned from CRP-EN and placed in use with DARS before the CRP-EN can partner with DARS and be eligible for EN Employment Advancement payments.

5.13.2 Definitions

CRP-EN

A provider of job placement and/or supported employment services under contract with DARS in accordance with these standards, and who is also under contract with the Social Security Administration (SSA) as an Employment Network.

EN Employment Advancement Payments

Payments to those DARS CRPs who are also under contract with the SSA as an Employment Network and who partner with DARS in an effort to ensure that VR consumers participating in the SSA's Ticket to Work Program receive job retention services and other types of services that advance employment or increase earnings after the consumer's VR case is closed.

Employment Networks (ENs)

Public or private entities that enter into an agreement with the Social Security Administration to provide employment, vocational, or other support services and help Ticket holders (consumers) obtain and maintain employment.

MAXIMUS

A private organization that contracts with the SSA to help manage the Ticket to Work Program.

Substantial Gainful Activity (SGA)

A level of consumer work activity and earnings defined by the SSA that includes the following concepts:

Substantial Work

Doing significant physical or mental activities, or a combination of both (full- or part-time).

Gainful Work

Work performed for pay or profit.

SGA is increased every January 1. Go to http://www.ssa.gov/OACT/COLA/sga.html to view the current amount.

105 percent of SGA

Amount calculated by identifying the SGA from the link above and then multiplying that amount by 1.05.

Tier Level (1 or 2)

A payment level assigned by a DARS counselor to a consumer receiving job placement or supported employment services and that is used as a basis for determining the amount of an EN Employment Advancement Payment.

Ticket

A paper document that is SSA's agreement to pay an EN the agreed-upon payments under the Ticket to Work Program.

5.13.3 EN Employment Advancement Payments

DARS offers a total of two EN Employment Advancement Payments to CRP-ENs who provide ongoing support services or job retention services that advance employment or increase earnings after a consumer's VR case is closed. Services provided by the CRP-EN must help the consumer meet the following outcomes:

  1. Consumer achieves one month of gross monthly pay that meets or exceeds SGA for the year in which the income was earned. This payment is available only during the first 12 months after VR case closure; and  
  2. Consumer achieves eight of twelve consecutive months of gross monthly pay that meets or exceeds 105 percent of SGA for the year in which the pay was earned. This payment is available only during the first 18 months after the first payment.

EN Employment Advancement Payment 1

Service Description

The CRP-EN provides services necessary for the consumer to retain and advance in employment to the point that the consumer can achieve one month of gross monthly pay that meets or exceeds SGA for the year in which the income was earned. This payment is available only during the first 12 months after VR case closure. For SE only, the CRP must be identified on the DARS1616, Job Stability or Service Closure Justification Summary as one of the primary providers helping the consumer achieve an identified long-term support need outlined in the DARS1616.  

The CRP-EN must notify the VR counselor, in writing, at least 30 days before the CRP-EN anticipates that the consumer will achieve the required income level, so that appropriate service authorization and/or purchase orders may be issued.

Required Documentation

The DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment is required. The form must be signed by the job placement services or supported employment provider. Written documentation (such as a Ticket Assignment confirmation letter from MAXIMUS or SSA Form 1365 completed and signed by the consumer and CRP-EN within 30 days of the invoice) must also be provided as proof that the consumer's Ticket is currently assigned to the CRP-EN.

One of the following must be attached to the DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment to provide evidence of consumer gross earnings: